Comparative efficacy and safety of Chinese patent medicines of iron deficiency anemia during pregnancy: A network meta-analysis

Table 1 Basic characteristics of the included studies

Ref.	Sample size T/C	Age (yr)		Duration of pregnancy (wk)		Intervention measures		Course	Outcome indicators
		T	C	T	C	T	C
Peng et al[18]	40/40	27.8 ± 5.3	27.1 ± 4.4	21.2 ± 4.3	20.6 ± 4.0	SXB + OI	OI	3 months	①②③④⑥⑦
Hu et al[19]	40/40	33.15 ± 3.15	33.37 ± 3.42	24.26 ± 2.11	24.52 ± 2.23	SXB + OI	OI	8 wk	①②③④⑦
Bi et al[20]	50/50	29.15 ± 2.46	29.64 ± 2.37	22.34 ± 0.87	22.56 ± 0.93	SXB + OI	OI	1 month	①②③④⑤⑥⑦
Zhang[21]	60/60	30.7 ± 5.0	31.6 ± 4.5	22.2 ± 3.8	21.2 ± 3.1	SXB + OI	OI	4 wk	①③④⑥⑦
Wang et al[22]	60/60	28.4 ± 3.6	28.5 ± 3.5	24.6 ± 1.3	24.5 ± 1.2	SXB + OI	OI	4 wk	②③④⑤⑥⑦
Ke et al[23]	40/40	29.74 ± 1.99	30.26 ± 2.08	22.37 ± 2.14	22.56 ± 2.03	SXB + OI	OI	3 months	①②③④⑤⑦
Yang et al[24]	56/56	28.52 ± 3.46	28.69 ± 3.81	27.53 ± 3.62	27.59 ± 3.31	SXN + OI	OI	4 wk	①②③④⑤⑥⑦
Wu[25]	40/40	30.25 ± 5.36	31.16 ± 5.48	-		SXN + OI	OI	1 month	①②③⑤⑥⑦
Peng[26]	40/40	29.44 ± 3.18	30.25 ± 3.11	28.71 ± 4.12	27.63 ± 4.19	SXN + OI	OI	4 wk	④⑤⑦
Yang[27]	80/80	29.0 ± 4.5	28.7 ± 4.1	22.6 ± 2.4	22.7 ± 2.6	SXN + OI	OI	4 wk	①②③④⑤
Chen et al[28]	44/44	27.51 ± 3.69	27.59 ± 3.75	29.58 ± 1.27	29.64 ± 1.32	SXN + OI	OI	4 wk	②③⑤
Sun et al[29]	33/34	28.93 ± 3.86	29.01 ± 3.92	23.53 ± 3.47	23.61 ± 3.51	SXN + OI	OI	4 wk	①②③⑤⑥⑦
Liu et al[30]	60/61	26.85 ± 3.35	27.12 ± 3.51	22.91 ± 2.37	23.07 ± 2.49	SXN + OI	OI	4 wk	②③⑤⑥
Fu et al[31]	39/39	25.3 ± 5.9	25.8 ± 5.2	21.0 ± 4.8	21.3 ± 4.4	SXN + OI	OI	30 d	②③⑤⑥⑦
Jiao[32]	50/50	26.74 ± 2.59	26.52 ± 2.78	33.41 ± 2.77	31.82 ± 2.23	SXN + OI	OI	28 d	①②③⑤
Gu[33]	50/50	30.1 ± 2.3		28.3 ± 1.5		SXN + OI	OI	4 wk	①②③
Ruan et al[34]	100/100	26.52 ± 2.74	26.14 ± 2.76	32.41 ± 2.61	31.86 ± 2.17	SXN + OI	OI	28 d	①②③⑤⑥
Li et al[35]	40/40	27.5 ± 2.8	27.9 ± 3.1	22.4 ± 6.3	22.0 ± 5.9	SXN + OI	OI	1 month	③⑦
Ji[36]	64/56	28.56 ± 1.58	28.13 ± 2.17	-		SXN + OI	OI	4 wk	①⑦
Zhao[37]	40/40	29.0 ± 2.0	9.54 ± 1.5	21.0 ± 1.5	20.5 ± 2.0	SXN + OI	OI	1 month	①②③⑤
Liu et al[38]	50/48	26.44 ± 4.58	26.89 ± 4.62	22.86 ± 3.88	23.03 ± 3.94	SXN + OI	OI	4 wk	①②③④⑤⑥⑦
Yin[39]	85/85	28.03 ± 5.68	27.91 ± 5.73	22.74 ± 7.05	22.58 ± 6.37	SXN + OI	OI	4 wk	①②③⑤
Chen[40]	42/42	26.1 ± 3.2	25.2 ± 2.1	20.5 ± 2.5	19.4 ± 2.2	SXN + OI	OI	1 month	①②③⑤⑥⑦
Sheng[41]	45/45	30.66 ± 4.06	30.85 ± 4.11	20.15 ± 1.25	20.98 ± 1.22	YQWX + OI	OI	12 wk	①③④⑤⑥⑦
Yu et al[42]	45/45	29.34 ± 6.84	30.20 ± 7.21	21.16 ± 1.20	21.42 ± 1.26	YQWX + OI	OI	3 months	①②③④⑤⑥
He[43]	40/40	29.64 ± 7.84	30.11 ± 7.68	21.46 ± 1.39	21.52 ± 1.37	YQWX + OI	OI	3 months	①②③④⑤⑥⑦
Ren et al[44]	43/43	32.12 ± 4.06	32.54 ± 4.17	22.45 ± 10.24	22.14 ± 10.14	YQWX+OI	OI	12 wk	①②③④⑥⑦
Zhang[45]	35/35	27.73 ± 3.78	27.25 ± 3.21	22.24 ± 1.89	22.31 ± 1.42	JPSX + OI	OI	4 wk	①③⑦
Yi[46]	30/30	29.01 ± 6.65	29.45 ± 6.71	24.51 ± 5.09	24.65 ± 5.13	JPSX + OI	OI	4 wk	①⑦
Wu et al[47]	50/50	29.4 ± 6.2	29.2 ± 4.6	19.8 ± 3.5	20.2 ± 3.9	JPSX + OI	OI	4 wk	①②③④⑤⑥⑦
Wu[48]	43/43	32.56 ± 4.29	31.96 ± 4.32	23.52 ± 3.18	23.40 ± 3.30	JPSX + OI	OI	1 month	①②③⑥⑦
Liu et al[49]	45/45	30.41 ± 7.43	30.29 ± 7.54	25.13 ± 8.70	25.21 ± 8.64	JPSX + OI	OI	4 wk	①③⑤⑦
Li[50]	40/40	33.4 ± 6.6	31.2 ± 6.5	20.4 ± 1.4	20.2 ± 1.5	JPSX + OI	OI	30 d	①②③④⑥
Xu[51]	53/53	23.15 ± 2.68	23.12 ± 2.82	23～34	22～33	JPSX + OI	OI	1 month	①②③④⑦
Wu[52]	35/35	28.03 ± 2.36	27.12 ± 5.16	24.03 ± 2.60	23.42 ± 3.22	JPSX + OI	OI	1 month	④⑤
Sun et al[53]	82/82	26.84 ± 3.57	27.35 ± 3.03	18.43 ± 2.06	17.87 ± 1.59	JPSX + OI	OI	3 months	①②③④⑤⑦
Shi et al[54]	65/64	27.38 ± 6.02	26.87 ± 5.14	23.02 ± 2.40	22.41 ± 3.12	JPSX + OI	OI	4 wk	①②③④⑤
Xiang et al[55]	32/33	24.2 ± 3.3	25.1 ± 3.4	22.9 ± 1.8	22.0 ± 1.3	JPSX + OI	OI	4 wk	①②③④⑦
Su et al[56]	30/30	26.8 ± 3.7	27.4 ± 4.2	22.6 ± 6.6	21.6 ± 6.0	JPSX + OI	OI	2 months	①②③④
Li et al[57]	48/48	27.36 ± 1.23	27.38 ± 1.26	18.53 ± 1.35	18.57 ± 1.38	JPSX + OI	OI	4 wk	①②③④
Wen et al[58]	60/60	26.6 ± 4.5	29.3 ± 2.6	22.8 ± 4.1	21.4 ± 3.1	YQBX + OI	OI	4 wk	③④⑤⑥
Liu et al[59]	40/40	28.6 ± 4.3	27.4 ± 3.2	23.8 ± 2.2	24.2 ± 2.1	YQBX + OI	OI	8 wk	①②③④⑥⑦
Luo et al[60]	50/50	28.3 ± 12.5	28.5 ± 12.4	21 ± 5	22 ± 4	YQBX + OI	OI	1 month	②③⑦
Jiang et al[61]	54/54	27.65 ± 5.92	26.85 ± 5.65	23.46 ± 5.58	24.37 ± 5.66	FFHY + OI	OI	4 wk	①③④⑤⑦
Zhang et al[62]	47/47	28.49 ± 3.20	28.15 ± 2.98	19.52 ± 2.19	19.12 ± 2.13	FFHY + OI	OI	4 wk	②③④⑦

T: Test group; C: Control group; OI: Oral iron; SXB: Shengxuebao Mixture; SXN: Shengxianning Tablet; YQWX: Yiqi Weixue Chinese patent medicines; JPSX: Jianpi Shengxue Chinese patent medicines; YQBX: Yiqi Buxue Tablets; FFHY: Compound Hongyi Buxue Oral Liquid; ① Clinical effective rate; ② Red blood cell level; ③ Hemoglobin level; ④ Serum ferritin level; ⑤ Serum iron level; ⑥ Adverse pregnancy outcomes; ⑦ Adverse events.

Table 2 Odds ratio/mean difference (95% credible interval) results of the network meta-analysis

Clinical effective rate	SXN + OI	YQWX + OI	JPSX + OI	YQBX + OI	FFHY + OI	OI
SXB + OI	0.78 (0.38, 1.60)	0.97 (0.37, 2.58)	1.03 (0.49, 2.18)	0.70 (0.20, 2.45)	1.76 (0.28, 11.22)	0.23 (0.12, 0.43)
SXN + OI		1.24 (0.55, 2.83)	1.31 (0.77, 2.25)	0.90 (0.29, 2.80)	2.25 (0.38, 13.29)	0.29 (0.21, 0.42)
YQWX + OI			1.06 (0.45, 2.48)	0.72 (0.19, 2.69)	1.81 (0.27, 12.04)	0.24 (0.11, 0.50)
JPSX + OI				0.68 (0.21, 2.17)	1.71 (0.29, 10.26)	0.22 (0.15, 0.34)
YQBX + OI					2.51 (0.32, 19.55)	0.33 (0.11, 0.97)
FFHY + OI						0.13 (0.02, 0.74)
Red blood cell level	SXN + OI	YQWX + OI	JPSX + OI	YQBX + OI	FFHY + OI	OI
SXB + OI	0.84 (0.34, 1.35)	0.32 (-0.38, 1.01)	-0.08 (-0.62, 0.45)	0.05 (-0.78, 0.89)	-0.27 (-1.32, 0.77)	-0.67 (-1.10, -0.25)
SXN + OI		-0.52 (-1.13, 0.08)	-0.93 (-1.34, -0.51)	-0.79 (-1.55, -0.03)	-1.12 (-2.10, -0.13)	-1.52 (-1.78, -1.26)
YQWX + OI			-0.40 (-1.04, 0.23)	-0.26 (-1.16, 0.64)	-0.59 (-1.69, 0.50)	-0.99 (-1.54, -0.45)
JPSX + OI				0.14 (-0.65, 0.92)	-0.19 (-1.20, 0.81)	-0.59 (-0.91, -0.27)
YQBX + OI					-0.33 (-1.52, 0.86)	-0.73 (-1.44, -0.01)
FFHY + OI						-0.40 (-1.35, 0.55)
Hemoglobin level	SXN + OI	YQWX + OI	JPSX + OI	YQBX + OI	FFHY + OI	OI
SXB + OI	17.40 (8.27, 26.54)	5.34 (-7.00, 17.68)	4.55 (-4.99, 14.09)	12.87 (-0.40, 26.14)	-1.66 (-17.20, 13.88)	-11.25 (-18.94, -3.56)
SXN + OI		-12.06 (-22.90, -1.22)	-12.85 (-20.35, -5.35)	-4.53 (-16.43, 7.36)	-19.06 (-33.45, -4.68)	-28.66 (-33.59, -23.72)
YQWX + OI			-0.79 (-11.97, 10.40)	7.53 (-6.97, 22.03)	-7.00 (-23.60, 9.60)	-16.59 (-26.25, -6.94)
JPSX + OI				8.32 (-3.89, 20.53)	-6.21 (-20.85, 8.43)	-15.81 (-21.45, -10.16)
YQBX + OI					-14.53 (-31.84, 2.78)	-24.12 (-34.94, -13.30)
FFHY + OI						-9.59 (-23.10, 3.92)
Serum ferritin level	SXN + OI	YQWX + OI	JPSX + OI	YQBX + OI	FFHY + OI	OI
SXB + OI	0.71 (-5.99, 7.41)	8.16 (1.27, 15.05)	-0.59 (-6.14, 4.96)	1.29 (-7.20, 9.79)	6.34 (-2.39, 15.08)	-5.41 (-9.68, -1.15)
SXN + OI		7.45 (-0.04, 14.94)	-1.30 (-7.57, 4.98)	0.59 (-8.39, 9.57)	5.64 (-3.58, 14.85)	-6.12 (-11.28, -0.95)
YQWX + OI			-8.74 (-15.21, -2.28)	-6.86 (-15.99, 2.26)	-1.81 (-11.16, 7.53)	-13.57 (-18.99, -8.15)
JPSX + OI				1.88 (-6.28, 10.04)	6.93 (-1.48, 15.34)	-4.82 (-8.38, -1.26)
YQBX + OI					5.05 (-5.54, 15.64)	-6.71 (-14.05, 0.64)
FFHY + OI						-11.75 (-19.38, -4.13)
Serum iron level	SXN + OI	YQWX + OI	JPSX + OI	YQBX + OI	FFHY + OI	OI
SXB + OI	4.31 (-0.28, 8.90)	1.83 (-4.09, 7.74)	3.48 (-1.79, 8.76)	3.34 (-5.01, 11.68)	0.64 (-7.85, 9.12)	-3.03 (-7.19, 1.12)
SXN + OI		-2.48 (-7.11, 2.15)	-0.83 (-4.61, 2.95)	-0.97 (-8.46, 6.52)	-3.67 (-11.31, 3.97)	-7.34 (-9.28, -5.40)
YQWX + OI			1.65 (-3.65, 6.96)	1.51 (-6.85, 9.87)	-1.19 (-9.69, 7.31)	-4.86 (-9.06, -0.66)
JPSX + OI				-0.14 (-8.07, 7.78)	-2.84 (-10.92, 5.23)	-6.51 (-9.76, -3.27)
YQBX + OI					-2.70 (-13.04, 7.64)	-6.37 (-13.60, 0.86)
FFHY + OI						-3.67 (-11.06, 3.72)
Adverse pregnancy outcomes	SXN + OI	YQWX + OI	JPSX + OI	YQBX + OI	OI
SXB + OI	0.79 (0.29, 2.12)	1.33 (0.45, 3.92)	0.72 (0.19, 2.63)	1.41 (0.35, 5.63)	3.04 (1.43, 6.48)
SXN + OI		1.69 (0.62, 4.63)	0.91 (0.26, 3.13)	1.80 (0.48, 6.77)	3.87 (2.03, 7.40)
YQWX + OI			0.54 (0.15, 2.00)	1.06 (0.26, 4.28)	2.29 (1.05, 4.97)
JPSX + OI				1.97 (0.41, 9.47)	4.25 (1.47, 12.28)
YQBX + OI					2.16 (0.68, 6.88)
Adverse events	SXN + OI	YQWX + OI	JPSX + OI	YQBX + OI	FFHY + OI	OI
SXB + OI	0.46 (0.19, 1.10)	1.03 (0.40, 2.68)	0.93 (0.41, 2.13)	0.29 (0.07, 1.11)	2.32 (0.75, 7.20)	1.47 (0.76, 2.86)
SXN + OI		2.23 (0.89, 5.56)	2.01 (0.92, 4.41)	0.62 (0.16, 2.31)	5.01 (1.71, 14.62)	3.18 (1.84, 5.51)
YQWX + OI			0.90 (0.36, 2.23)	0.28 (0.07, 1.12)	2.24 (0.69, 7.25)	1.43 (0.69, 2.96)
JPSX + OI				0.31 (0.08, 1.15)	2.49 (0.85, 7.31)	1.58 (0.91, 2.77)
YQBX + OI					8.11 (1.79, 36.78)	5.16 (1.55, 17.11)
FFHY + OI						0.64 (0.25, 1.60)

OI: Oral iron; SXB: Shengxuebao Mixture; SXN: Shengxianning Tablet; YQWX: Yiqi Weixue Chinese patent medicines; JPSX: Jianpi Shengxue Chinese patent medicines; YQBX: Yiqi Buxue Tablets; FFHY: Compound Hongyi Buxue Oral Liquid.

Table 3 The surface under the cumulative ranking curve for outcomes

	Clinical effective rate (%)	RBC (%)	Hb (%)	SF (%)	SI (%)	Incidence of adverse pregnancy outcomes (%)	Adverse events (%)
SXB + OI	62.2	49.5	33.2	40.9	33.3	60.6	47.4
SXN + OI	41.4	98.7	96	46.8	81.9	75.3	85.3
YQWX + OI	59.1	71.9	54.9	92.3	51.4	43.3	45.1
JPSX + OI	66	41.7	52.9	35.6	71	77.1	52.2
YQBX + OI	40.5	52.5	81.7	51.1	65.5	41.4	94
FFHY + OI	80.2	32.1	30.1	82.2	42	-	6.3
OI	0.5	3.7	1.4	1	4.8	2.4	19.7

OI: Oral iron; SXB: Shengxuebao Mixture; SXN: Shengxianning Tablet; YQWX: Yiqi Weixue Chinese patent medicines; JPSX: Jianpi Shengxue Chinese patent medicines; YQBX: Yiqi Buxue Tablets; FFHY: Compound Hongyi Buxue Oral Liquid; RBC: Red blood cells counts; Hb: Hemoglobin; SF: Serum ferritin; SI: Serum iron.