Meta-Analysis
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2024; 12(18): 3515-3528
Published online Jun 26, 2024. doi: 10.12998/wjcc.v12.i18.3515
Comparative efficacy and safety of Chinese patent medicines of iron deficiency anemia during pregnancy: A network meta-analysis
Jia-Chen Zou, Xian-Ling Jia, Hai-Xia Wang, Ying-Jie Su, Jing-Yu Zhu
Jia-Chen Zou, Xian-Ling Jia, School of Chinese Medicine, Weifang Medical University, Weifang 261053, Shandong Province, China
Hai-Xia Wang, Ying-Jie Su, Jing-Yu Zhu, Traditional Chinese Medicine Department, Affiliated Hospital of Weifang Medical University, Weifang 261031, Shandong Province, China
Author contributions: Zou JC contributed to conceptualization, software, data curation, writing-Original draft preparation; Wang HX contributed to conceptualization, methodology; Jia XL contributed to reviewing, editing, data curation and validation; Su YJ contributed to visualization, investigation, funding acquisition; Zhu JY contributed to software, validation, writing- reviewing and editing.
Supported by Shandong Province Traditional Chinese Medicine Science and Technology Project, No. Q-2022126; and Weifang Municipal Health Commission Traditional Chinese Medicine Scientific Research Project, No. 014, 2022 (Category 3).
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hai-Xia Wang, PhD, Chief Doctor, Traditional Chinese Medicine Department, Affiliated Hospital of Weifang Medical University, No. 2428 Yuhe Road, Kuiwen District, Weifang 261031, Shandong Province, China. wsy852893@163.com
Received: March 4, 2024
Revised: April 25, 2024
Accepted: May 15, 2024
Published online: June 26, 2024
Processing time: 106 Days and 1.4 Hours
Abstract
BACKGROUND

Iron deficiency anemia (IDA) is a prevalent nutritional disorder during pregnancy. Clinical studies indicate that incorporating Chinese patent medicines (CPMs) with oral iron (OI) in treating IDA in pregnancy can reduce adverse effects and improve clinical outcomes. Nonetheless, the comparative efficacy of different CPMs remains unclear.

AIM

To assess the safety and effectiveness of different CPMs for treating IDA during pregnancy using network meta-analysis.

METHODS

We conducted a search for randomized controlled trials (RCTs) that combined CPM and OI for IDA treatment in pregnancy, spanning from 2013 to the present. Data analysis was performed using Rev Man 5.3 and Stata 14.0 on literature that satisfied the quality criteria.

RESULTS

The analysis included 45 RCTs, encompassing 4422 pregnant patients with IDA. Six CPMs were examined, including Shengxuebao Mixture, Shengxuening Tablets (SXN), Yiqi Weixue CPMs (YQWX), Jianpi Shengxue CPMs (JPSX), Yiqi Buxue Tablets, and Compound Hongyi Buxue Oral Liquid (FFHY). Findings indicated that FFHY + OI significantly improved the clinical effective rate. SXN + OI was most effective in boosting red blood cells counts and hemoglobin levels. YQWX + OI showed superior results in improving serum ferritin, and SXN + OI was most effective in increasing serum iron levels. JPSX + OI was optimal in reducing adverse pregnancy outcomes, while YQBX + OI effectively minimized adverse events. A cluster analysis suggested that SXN + OI could be the potentially optimal therapeutic regimen for IDA in pregnancy.

CONCLUSION

This study demonstrates that the combination of OI with CPMs offers better outcomes than OI alone. Based on clinical efficacy and other measured outcomes, SXN + OI emerges as the most effective treatment modality for improving the health of pregnant patients with IDA.

Keywords: Chinese patent medicine; Network meta-analysis; Shengxuebao Mixture; Shengxuening Tablets; Yiqi Weixue Chinese patent medicines; Jianpi Shengxue Chinese patent medicines; Yiqi Buxue Tablets; Compound Hongyi Buxue Oral Liquid

Core Tip: The network meta-analysis demonstrated that combining Chinese proprietary medicines with oral iron (OI) for the treatment of iron-deficiency anaemia in pregnancy significantly improved clinical effective rate, improved red blood cell indicators and iron metabolism indicators, and reduced adverse pregnancy outcomes and adverse events. Based on the available evidence, it is recommended that the combination of Shengxuening Tablets with OI improve clinical efficacy and other outcome indicators. Further high-quality randomised controlled trials are needed to reassess or confirm this finding.