Background: The aim of this network meta-analysis (NMA) was to compare the effectiveness and safety of different Chinese patent medicines (CPMs) combined with Western medicines (WMs) regimen versus WMs alone in the treatment of Helicobacter pylori-related gastric ulcer (GU). Methods: A comprehensive search was conducted on databases from their inception to May 31, 2023, to identify all randomized controlled trials (RCTs) that investigated the efficacy of CPMs in combination with conventional WMs in the treatment of patients with H pylori-related GU. Using Cochrane risk of bias assessment tool, we evaluated the methodological quality of RCTs. R version 4.2.3 and Stata version 15.1 software were cross-merged to conduct pairwise NMA. Results: A total of 35 studies involving 4667 patients and 11 CPMs were identified. Eleven CPMs were analyzed, including Pingwei Capsule (PWC), Kangfuxin Solution (KFXS), Shugan Jieyu Capsule (SGJYC), Weisu Granule (WSG), Qiwei Weitong Capsule (QWWTC), Beiling Weitong Granule (BLWTG), Anweiyang Capsule (AWYC), Jinghua Weikang Capsule (JHWKC), Weifuchun Tablet (WFCT), Wenweishu Capsule (WWSC), and Weidean Capsule (WDAC). Results showed that the combination of CPM and WM was more effective relative to the WM regimen alone. NMA revealed that WWSC combined with the WM yielded superior results in enhancing clinical outcomes and mitigating GU recurrence rates. PWC combined with the WM showed the best performance in improving the H pylori eradication rate. WFCT combined with the WM had the most optimal performance in controlling gastrin (GAS) and motilin (MTL) levels. KFXS combined with the WM showed the best results in terms of reducing the incidence of adverse events. Conclusion: Our NMA findings indicate that the combination of WWSC, PWC, WFCT, and KFXS with WM may be more effective and advantageous outcomes compared to other CPMs. Due to the limitations of this study, future research should employ larger sample sizes and multicenter RCTs to conduct real-world clinical studies.

Background: The study aimed to conduct a network meta-analysis of randomized controlled trials (RCTs) to examine the effectiveness and safety of traditional Chinese patent medicine (TCPM), either used alone or combined with conventional treatment (CT) of chemical drugs, for treating chronic atrophic gastritis (CAG). Methods: We searched the literature from database creation to December 2023; our primary endpoint was clinical response rate. Secondary outcome measures were the inhibition rate of Helicobacter pylori and clinical symptom score, including pain and noisy scores for the stomach, score for belch and acid reflux, score for the bitter taste and the dry throat, and safety according to total adverse events. Data analyzed using RevMan 5.3, R (v4.0.2), and Stata SE 15.0. Mean differences (MDs) for continuous outcomes and odds ratios (ORs) for dichotomous outcomes and drug ranking by P-score. Network meta-analysis presented as forest plot and league table. Results reported as MDs/ORs with 95% confidence interval (CI). Results: Our analysis comprised 49 RCTs with 5218 patients. Compared to using CT alone, all TCPMs + CT performed better in improving clinical response rate. The Weifuchun tablet (WFCT) inhibition rate (OR = 9.05; 95% CI = 1.89–43.34; P-score = .92) was relatively high, but only 1 RCT supported this result. WFCT + CT (OR = 2.94; 95% CI = 1.97–4.39; P-score = .57), Qizhiweitong granule (QZWTG) + CT (OR = 2.91; 95% CI = 1.07–7.89; P-score = .55), and Moluodan (MLD) + CT (OR = 2.44; 95% CI = 1.37–4.36; P-score = .43) had certain advantages in inhibiting H pylori compared to using CT alone. Compared with CT, Weisu tablet (WST) + CT (OR = 0.21; 95% CI = 0.05–0.89; P-score = .24) and Xiangshayangwei pill (XSYWP) + CT (OR = 0.41; 95% CI = 0.18–0.92; P-score = .44) were drugs that were less likely to cause adverse reactions. Conclusion: Our results demonstrate that, compared to using CT alone, TCPMs combined with CT can improve the clinical response rate in the treatment of CAG. Additionally, some TCPMs combined with CT can enhance the H pylori inhibition rate. WST + CT and XSYWP + CT can even reduce the occurrence of adverse reactions.