Chinese Medical Injections for Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Network Meta-analysis

Figures & data

Figure 1 PRISMA flow diagram.

Table 1 The Characteristics of Included Studies

Study	Sample size		Gender		Age (years)		Interventions		Courses (days)	Outcomes
	T1 (T2)	C	Male	Female	T1 (T2)	C	T1(T2)	C
Cai Lili 2014^Citation57	55	55	69	41	75±4.8	74±5.4	WM+KA	WM	14	②⑤⑪⑫
Chen Weizhong 2014^Citation58	77	77	89	65	64.7±12.2	65.8±11.8	WM+RDN	WM	7	②③⑤⑪⑫
Chen Zhuo 2013^Citation59	52	48	60	40	66.6±7.4	63.8±7.8	WM+DH	WM	14	②
Chi Yongsheng 2015^Citation60	48	48	42	54	76.45±5.66	77.68±6.21	WM+SF	WM	14	②⑤
Cui Yandong 2010^Citation61	24	24	31	17	50–74	51–76	WM+CKZ	WM	14	②
Dong Hongzhen 2015^Citation62	30	30	39	21	62.3±1.9	61.3±2.1	WM+RDN	WM	7	②
Du Jin 2014^Citation63	30	30	34	26	65±8.4	62±9.8	WM+DH	WM	14	②⑧
Du Yong 2015^Citation64	60	60	82	38	67.54±10.66	66.38±11.34	WM+TRQ	WM	10	②
Duan Limin 2015^Citation65	46	46	63	29	70.3±5.8	70.3±5.8	WM+XBJ	WM	7	②
Fan Yongxia 2011^Citation66	25	25	29	21	58	57	WM+DH	WM	14	②
Feng Qing 2015^Citation67	33	32	38	27	62±5.0	64±6.0	WM+TRQ	WM	7	②
Feng Zhijun 2010^Citation68	54	52	67	39	64.5±6.8	64.5±6.8	WM+TRQ	WM	–	②
Fu Dongwei 2012^Citation69	35	35	41	29	61.45±5.23	59.57±5.84	WM+TRQ	WM	15	②
Fu Qin 2009^Citation70	50	50	92	8	80~93	81~94	WM+TRQ	WM	7~10	②
Fu Yongwang 2009^Citation71	65	63	68	60	61.2±1.2	61.8±2.8	WM+TRQ	WM	10	②⑤
Ge Zhongkai 2015^Citation72	30	30	39	21	53.1±8.5	52.6±8.2	WM+TRQ	WM	10	②③⑪
Ge Zhongkai 2016^Citation73	32	32	41	23	54.9±4.4	55.7±4.6	WM+DH	WM	14	②
Guo Xia 2009^Citation74	35	35	40	30	67	66	WM+SM	WM	15	②
Han Fang 2015^Citation75	62	60	70	52	56	61	WM+XYP	WM	14	③⑤⑫
Hao Tianpao 2010^Citation76	30	30	42	18	66±6	67±5	WM+XBJ	WM	10	②
He Shaoling 2019^Citation77	44	44	60	28	57.97±7.56	58.31±6.86	WM+XBJ	WM	14	②⑪⑫
He Xiang 2016^Citation78	35	35	56	14	69.39±7.56	70.24±6.89	WM+TRQ	WM	7	②⑤
He Yongliang 2012^Citation79	40	42	58	24	63.4±10.3	62.8±10.5	WM+DS	WM	10~14	②
Hu Xiaolin 2016^Citation80	50(50)	50	115	35	69.3±6.3(66.7±4.2)	68.4±5.8	WM+XBJ(WM+TRQ)	WM	7	②③⑥
Hua Wenshan 2014^Citation81	20	20	21	19	55~80	50~75	WM+TRQ	WM	–	②
Huang Bin 2006^Citation82	30	30	45	15	64.21±8.21	64.21±8.21	WM+TRQ	WM	14	②③⑤
Kang Jin 2016^Citation83	60	60	69	51	44.37±13.25	45.36±14.85	WM+TRQ	WM	7	②
Li Daxiang 2015^Citation84	33	33	33	33	53.1±1.3	55.8±7.7	WM+XBJ	WM	3	②⑤
Li Guoling 2009^Citation85	36	36	53	19	72.25±9.340	71.50±9.637	WM+TRQ	WM	–	②④
Li Linlin2014^Citation86	38	38	42	34	64.3±3.2	66.3±3.8	WM+TRQ	WM	7	②④
Li Wen 2010^Citation87	28	26	35	19	67.1±7.1	67.8±8.2	WM+TRQ	WM	10	①②
Liang Gang 2009^Citation88	30	30	41	19	81.2±6.8	80.1±6.5	WM+DS	WM	14	②⑤
Liang Wei 2017^Citation89	35	35	45	25	62.34±5.52	61.76±5.59	WM+TRQ	WM	7	②
Liao Wensheng 2008^Citation90	30	28	39	19	68.3±7.4	65.2±5.9	WM+SF	WM	14	②⑪⑫
Ling Daobo 2009^Citation91	30	30	44	16	71.5	70.8	WM+XBJ	WM	7	②⑧
Liu Hongbo 2008^Citation92	60	60	79	41	64.24±12.35	63.55±11.35	WM+TRQ	WM	14	②③⑤⑦⑫
Liu Honghong 2016^Citation93	30	30	33	27	69.00±5.73	68.10±5.94	WM+XYP	WM	–	②④⑪⑫
Liu Yan 2019^Citation94	30	30	32	28	60.53±8.42	63.71±9.52	WM+SXT	WM	14	②③⑤⑪⑫
Liu Zhanxiang 2007^Citation95	100	98	103	95	61.2±1.2	61.8±2.8	WM+TRQ	WM	7	②
Liu Zhonggui 2014^Citation96	56	54	65	45	63.1±2.5	63.1±2.5	WM+TRQ	WM	10	②③⑪
Long Hai 2012^Citation97	64	60	88	36	61.10±7.21	61.12±12.35	WM+TRQ	WM	7	②③⑤⑪
Lu Na 2013^Citation98	49	49	71	27	72.2	71.5	WM+TRQ	WM	14	②⑦
Mu Lin 2014^Citation99	36	36	43	29	51~82	51~82	WM+XBJ	WM	7	②⑤
Pang Lijian 2015^Citation100	55	55	51	59	55±4.25	54±3.65	WM+RDN	WM	14	②⑤
Peng Bo 2007^Citation101	30	30	35	25	60.3±6.6	59.3±8.18	WM+TRQ	WM	12	②⑫
Qiu Qin 2013^Citation102	35	35	48	22	72.4±11.3	72.4±11.3	WM+XBJ	WM	10	②⑧⑪⑫
Qu Qiu2014^Citation103	30	30	44	16	78±5.7	78±5.7	WM+HJT	WM	10	②⑤
Ren Yuejuan 2013^Citation104	35	35	41	29	62.5±5.4	62.8±5.01	WM+SF	WM	14	②⑤
Shi Ce 2009^Citation105	25	25	37	13	45~75	46~77	WM+TRQ	WM	7~14	②
Shi Daihui 2013^Citation106	42	42	54	30	55~84	56~82	WM+TRQ	WM	10	②⑤
Shi Yiying 2009^Citation107	23	23	27	19	58	57	WM+DH	WM	14	②⑪⑫
Song Liang 2012^Citation108	40	40	58	22	52–82	54–84	WM+CKZ	WM	7	②
Sun Jin 2008^Citation109	75	63	–	–	–	–	WM+TRQ	WM	14	②⑦
Tang Na 2016^Citation110	60	60	87	33	62.8±9.6	63.1±9.5	WM+TRQ	WM	–	②③④⑪
Tang Wei 2012^Citation111	56	56	65	47	72.5±5.0	71.0±4.2	WM+HQ	WM	21	②
Tian Rukang 2009^Citation112	38	34	40	32	68	66	WM+SM	WM	15	②⑤
Tian Tulie 2015^Citation113	37	37	42	32	60.8	59.7	WM+RDN	WM	10	②⑪⑫
Wang Aidong 2011^Citation114	72	70	100	42	61.8±6.3	64.7±8.6	WM+TRQ	WM	10~14	②⑤⑪⑫
Wang Haiyan 2010^Citation115	30	30	41	19	64	62	WM+DZXX	WM	10	②③⑪
Wang Lixia 2008^Citation116	50	46	59	37	68.5	67.2	WM+TRQ	WM	7~14	②
Wang Qiu 2013^Citation117	47	47	67	27	60.4	60.4	WM+TRQ	WM	10	②⑦
Wang Tiejun 2012^Citation118	39	40	50	29	55.76±8.23	56.36±7.69	WM+SXN	WM	14	③⑥
Wang Tongbing 2015^Citation119	46	46	53	39	59.26±2.68	59.26±2.68	WM+TRQ	WM	14	②③⑤⑪
Wang Xianghua 2011^Citation120	39	39	46	32	62.7±4.8	58.8±6.1	WM+TRQ	WM	14	②③⑤⑪
Wang Xueqin 2015^Citation121	30	30	29	31	69.6	71.0	WM+XBJ	WM	7	②
Wang Yong 2007^Citation122	32	28	51	9	69.5±7.8	69.3±8.0	WM+SGM	WM	14	②④⑤⑥⑦
Wei Sizun 2011^Citation123	40	40	44	36	59.28±8.56	58.08±9.28	WM+TRQ	WM	–	②③⑪
Wei Yaomin 2014^Citation124	37	33	39	31	61.3±2.5	61.3±2.5	WM+RDN	WM	10	②③⑪
Wnag Yuanjun 2012^Citation125	50	50	69	31	40~65	40~65	WM+XBJ	WM	7	②
Wu Beishou 2015^Citation126	38	38	39	37	50.7±9.3	53.6±6.8	WM+Salvianolate	WM	14	②
Wu Dengxiang 2015^Citation127	50	50	56	44	52.5±5.7	53.4±6.7	WM+TRQ	WM	15	②⑤
Wu Yi 2017^Citation128	40	40	52	28	66±6	67±5	WM+CKZ	WM	7	②
Xia Chunxia 2010^Citation129	40	40	58	22	69.9±11.3	69.1±10.9	WM+KDZ	WM	14	②⑤
Xiang Wei 2012^Citation130	44	42	43	43	32.5±2.3	39.85±1.73	WM+CKZ	WM	7	②
Xiang Zhi 2020^Citation131	60	60	68	52	68.01±10.28	67.25±9.4	WM+TRQ	WM	10	④⑤⑫
Xiao Chenxi 2018^Citation132	45	44	53	36	68.14±9.41	67.15±8.62	WM+HQ	WM	14	②④⑨⑩
Xie Yonghong 2005^Citation133	52	30	49	33	63.67±8.21	63.41±9.35	WM+TRQ	WM	15	②⑤⑦
Xiong Suqiong 2013^Citation134	56	56	63	49	66.7	66.5	WM+HQ	WM	14	②
Xu Weijun 2017^Citation135	32	36	44	24	73.60±10.60	75.00±8.30	WM+TRQ	WM	14	②⑤⑪⑫
Yang Jiewu 2012^Citation136	110	110	149	71	56.60±6.20	56.60±6.20	WM+DH	WM	14	②⑪⑫
Yang Ruifang 2010^Citation137	42	40	63	19	66.5±5.8	67.2±4.6	WM+DH	WM	14	②
Yang Weizhong 2014^Citation138	60	60	78	42	70.0±6.4	70.0±6.4	WM+TRQ	WM	7	②④
Yang Xiuhong 2006^Citation139	14	12	16	10	62.8±11.2	62.8±11.2	WM+TRQ	WM	10	②
Ye Ling 2010^Citation140	30	27	50	7	–	–	WM+XBJ	WM	10	②⑤⑧⑪⑫
YE Shihua 2016^Citation141	40	40	45	35	62.8±3.4	62.4±3.9	WM+RDN	WM	35	②⑪⑫
Yin Libo 2009^Citation142	32	30	44	18	73.38±7.61	74±10.47	WM+TRQ	WM	10	②⑤
YU Changxiu 2020^Citation143	42	42	56	28	56.5±2.3	57.5±2.1	WM+SM	WM	14	②③
Zhang Chimei 2014^Citation144	30	28	35	23	65.1±5.4	63.8±5.1	WM+HQ	WM	14	②
Zhang Li 2013^Citation145	60	60	56	64	70.6±3.3	70.6±3.3	WM+DH	WM	14	②
Zhang Liyun 2017^Citation146	30	30	51	9	64.51±11.31	65.04±12.42	WM+ZCL	WM	7	②
Zhang Qiang 2015^Citation147	30	30	42	18	66.5±8	64.8±10	WM+QKL	WM	14	②⑪
Zhang Qiong 2014^Citation148	64	64	71	57	64.45±9.46	64.41±9.45	WM+DH	WM	14	②
Zhang Wenqian 2010^Citation149	36	36	49	23	60.4	61.5	WM+QKL	WM	7	②⑤
Zhang Xiaohua 2016^Citation150	47	47	75	19	50–82	53–75	WM+HH	WM	15	②
Zhang Xin 2014^Citation151	46	46	62	30	67.8±7.4	67.6±7.2	WM+XYP	WM	14	②③⑪
Zhang Ying 2004^Citation152	29	29	38	20	71.48±7.72	69.34±7.83	WM+TRQ	WM	12	①②⑥⑦
Zhang Yuanhua 2015^Citation153	35	35	45	25	65	66	WM+KDZ	WM	10	②
Zhao Zhenhuan 2016^Citation154	50	50	74	26	64.8±6.9	68.3±7.8	WM+SHL	WM	10	②
Zhang Yali 2017^Citation155	45	44	57	32	65.9±13.4	66.4±12.8	WM+SF	WM	14	②⑤⑪⑫
Zhou Aizhu 2013^Citation156	20	20	35	5	62±4.5	62±4.5	WM+XST	WM	14	②⑤⑪⑫
Zhou Jianguo 2014^Citation157	30	30	32	28	72.6±5.4	73.1±5.8	WM+RDN	WM	7	①②
Zhou Zhong 2009^Citation158	72	50	83	39	63.67±7.25	65.27±9.35	WM+TRQ	WM	10~14	②⑤
Zuo Xiqing 2010^Citation159	30	30	48	12	70.35±5.12	70.85±4.04	WM+DH	WM	14	②⑤

Notes: ① Chinese Medical Symptom Scores; ② Clinical efficacy; ③ FEV₁; ④ Length of hospital stay; ⑤ Blood gas analysis; ⑥ Blood routine examination; ⑦ Sign; ⑧ Blood coagulation function; ⑨ Immunologic function; ⑩ Mechanical ventilation index; ⑪ FEV₁/FVC; ⑫ FEV₁  %  .

Abbreviations: T1, treatment group 1; T2, treatment group 2; C, control group; WM, conventional Western medical therapy; CKZ, Chuankezhi injection; DH, Danhong injection; DS, Danshen injection; DZXX, Dengzhanxixin injection; HH, Honghua injection; HJT, Hongjingtian injection; HQ, Huangqi injection; KA, Kangai injection; KDZ, Kudiezi injection; QKL, Qingkailing injection; RDN, Reduning injection; SF, Shenfu injection; SGM, Shengmai injection; SM, Shenmai injection; SHL, Shuanghuanglian injection; SXN, Shuxuening injection; SXT, Shuxuetong injection; TRQ, Tanreqing injection; XYP, Xiyanping injection; XBJ, Xuebijing injection; XST, Xuesaitong injection; ZCL, Zhichuanling injection; Salvianolate, Salvianolate injection.

Figure 2 Assessment of the risk of bias.

Figure 3 Network plot. (A) Clinical efficacy (B) FEV_1, (C) FEV₁/FVC, (D) FEV₁%, (E) Length of hospital stay.

Abbreviations: WM, conventional Western medical therapy; CKZ, Chuankezhi injection; DH, Danhong injection; DS, Danshen injection; DZXX, Dengzhanxixin injection; HH, Honghua injection; HJT, Hongjingtian injection; HQ, Huangqi injection; KA, Kangai injection; KDZ, Kudiezi injection; QKL, Qingkailing injection; RDN, Reduning injection; SF, Shenfu injection; SGM, Shengmai injection; SM, Shenmai injection; SHL, Shuanghuanglian injection; SXN, Shuxuening injection; SXT, Shuxuetong injection; TRQ, Tanreqing injection; XYP, Xiyanping injection; XBJ, Xuebijing injection; XST, Xuesaitong injection; ZCL, Zhichuanling injection; Salvianolate, Salvianolate injection.

Table 2 The Results of Network Meta-analysis of Clinical Efficacy

OR (95%CI)	WM	WM+CKZ	WM+DH	WM+DS	WM+DZXX	WM+HH	WM+HJT	WM+HQ	WM+KA	WM+KDZ	WM+QKL	WM+RDN	WM+SF	WM+SGM	WM+SM	WM+SHL	WM+SXT	WM+TRQ	WM+XYP	WM+XBJ	WM+XST	WM+ZCL	WM+Salvianolate
WM	1
WM+CKZ	5.37 (1.93, 12.25)^a	1
WM+DH	6.34 (3.02,11.96)^a	1.47 (0.39,3.91)	1
WM+DS	6.89 (1.33,22.74)^a	1.6 (0.21,6.11)	1.23 (0.19,4.44)	1
WM+DZXX	115.4 (1.42,514)^a	27.03 (0.25,116.9)	20.44 (0.21,92.44)	27.07 (0.18,126.2)	1
WM+HH	5.25 (0.75,19.02)	1.22 (0.12,5.01)	0.94 (0.11,3.66)	1.29 (0.08,6.02)	0.72 (0.01,4.43)	1
WM+HJT	15.36 (0.95,77.41)	3.59 (0.16,18.94)	2.75 (0.14,14.33)	3.79 (0.11,21.22)	2.15 (0.01,13.97)	5.82 (0.14,33.05)	1
WM+HQ	2.21 (0.86,4.74)	0.51 (0.12,1.46)	0.39 (0.11,1.02)	0.54 (0.07,1.95)	0.3 (0,1.65)	0.83 (0.09,3.35)	0.53 (0.02,2.55)	1
WM+KA	14.96 (0.99,73.39)	3.5 (0.17,17.86)	2.67 (0.15,13.46)	3.6 (0.12,20.09)	2.02 (0.01,12.95)	5.61 (0.15,32.05)	3.52 (0.05,21.2)	8.16 (0.41,41.85)	1
WM+KDZ	6.88 (1.18,24.15)^a	1.6 (0.19,6.45)	1.23 (0.17,4.67)	1.69 (0.12,7.76)	0.95 (0.01,5.77)	2.59 (0.15,12.57)	1.65 (0.04,9.18)	3.76 (0.46,14.88)	1.63 (0.05,8.9)	1
WM+QKL	5.86 (1.04,20.03)^a	1.36 (0.16,5.33)	1.05 (0.15,3.9)	1.44 (0.11,6.5)	0.81 (0.01,4.85)	2.21 (0.13,10.72)	1.4 (0.04,7.71)	3.2 (0.41,12.34)	1.39 (0.04,7.5)	1.55 (0.1,7.1)	1
WM+RDN	4.65 (2.11,9.08)^a	1.08 (0.28,2.92)	0.83 (0.27,1.99)	1.14 (0.16,3.95)	0.64 (0.01,3.42)	1.75 (0.2,6.88)	1.11 (0.05,5.26)	2.53 (0.71,6.57)	1.1 (0.05,5.04)	1.22 (0.15,4.42)	1.41 (0.18,4.98)	1
WM+SF	4.87 (1.59,11.89)^a	1.13 (0.23,3.49)	0.87 (0.21,2.46)	1.2 (0.14,4.52)	0.67 (0.01,3.78)	1.83 (0.17,7.66)	1.16 (0.05,5.71)	2.66 (0.57,7.99)	1.16 (0.05,5.61)	1.29 (0.13,5.07)	1.47 (0.16,5.7)	1.2 (0.29,3.42)	1
WM+SGM	12.96 (0.76,65.29)	3 (0.13,16)	2.3 (0.11,12.04)	3.19 (0.09,17.75)	1.76 (0.01,11.57)	4.92 (0.11,28.38)	3.15 (0.04,19.09)	7.01 (0.32,37.55)	3.15 (0.04,18.65)	3.37 (0.09,19.29)	3.88 (0.11,22.07)	3.2 (0.15,16.77)	3.47 (0.14,18.65)	1
WM+SM	4.51 (1.14,12.99)^a	1.05 (0.17,3.64)	0.81 (0.16,2.58)	1.11 (0.11,4.54)	0.62 (0.01,3.58)	1.71 (0.13,7.64)	1.08 (0.04,5.59)	2.46 (0.43,8.31)	1.07 (0.04,5.42)	1.19 (0.1,5.01)	1.37 (0.12,5.73)	1.12 (0.21,3.6)	1.21 (0.18,4.28)	1.33 (0.04,6.94)	1
WM+SHL	12.92 (0.85,64.72)	3 (0.14,15.91)	2.3 (0.13,11.9)	3.17 (0.1,17.66)	1.78 (0.01,11.62)	4.87 (0.13,28.5)	3.1 (0.04,18.82)	7.05 (0.35,36.75)	3.11 (0.04,18.92)	3.42 (0.1,19.23)	3.91 (0.12,22.12)	3.22 (0.17,16.58)	3.44 (0.16,18.34)	3.82 (0.05,23.59)	4.19 (0.16,22.9)	1
WM+SXT	8.69 (0.5,44.36)	2.04 (0.08,10.84)	1.55 (0.07,8.18)	2.15 (0.06,12.23)	1.21 (0,7.84)	3.33 (0.08,19.25)	2.09 (0.02,12.94)	4.73 (0.21,25.34)	2.08 (0.03,12.69)	2.3 (0.06,13.14)	2.63 (0.07,15.04)	2.14 (0.1,11.31)	2.32 (0.09,12.57)	2.54 (0.03,15.88)	2.83 (0.09,15.53)	2.36 (0.03,14.39)	1
WM+TRQ	4.48 (3.28,6.02)^a	1.04 (0.34,2.41)	0.8 (0.35,1.56)	1.1 (0.19,3.46)	0.62 (0.01,3.19)	1.69 (0.23,6.1)	1.07 (0.06,4.8)	2.45 (0.89,5.39)	1.06 (0.06,4.59)	1.18 (0.18,3.9)	1.35 (0.21,4.4)	1.11 (0.46,2.24)	1.2 (0.36,2.91)	1.32 (0.07,5.99)	1.46 (0.33,4.03)	1.21 (0.07,5.31)	1.98 (0.1,9.17)	1
WM+XYP	2.93 (0.64,8.76)	0.68 (0.1,2.42)	0.52 (0.09,1.73)	0.72 (0.06,3)	0.4 (0,2.38)	1.1 (0.08,5.04)	0.7 (0.02,3.7)	1.6 (0.25,5.49)	0.69 (0.02,3.53)	0.77 (0.06,3.34)	0.88 (0.07,3.77)	0.72 (0.12,2.43)	0.78 (0.11,2.84)	0.86 (0.03,4.53)	0.95 (0.11,3.69)	0.79 (0.03,4.08)	1.28 (0.04,6.84)	0.67 (0.14,2.04)	1
WM+XBJ	3.52 (1.91,6.1)^a	0.82 (0.24,2.08)	0.63 (0.23,1.4)	0.86 (0.13,2.88)	0.48 (0.01,2.56)	1.33 (0.16,5.04)	0.84 (0.04,3.9)	1.92 (0.6,4.69)	0.83 (0.04,3.74)	0.93 (0.13,3.22)	1.06 (0.15,3.64)	0.87 (0.31,1.99)	0.94 (0.25,2.51)	1.03 (0.05,4.84)	1.14 (0.23,3.39)	0.95 (0.05,4.34)	1.55 (0.07,7.4)	0.8 (0.4,1.46)	1.87 (0.34,5.99)	1
WM+XST	82.43 (0.5228.6)	17.99 (0.09,53.05)	15.58 (0.08,40.28)	17.17 (0.06,55.81)	6.33 (0.01,30.04)	59.16 (0.08,85.58)	21.27 (0.03,52.97)	41.88 (0.22,125.1)	17.74 (0.03,52.69)	22.32 (0.06,59.95)	22.45 (0.08,69.31)	19.3 (0.1,56.43)	22.14 (0.1,61.29)	21.12 (0.03,65.18)	25.91 (0.1,74.21)	15.18 (0.03,59.7)	44.7 (0.05,97.04)	18.3 (0.11,52.22)	40.23 (0.16,122.1)	22.91 (0.14,71.32)	1
WM+ZCL	7.36 (0.38,37.47)	1.71 (0.06,9.09)	1.31 (0.06,6.91)	1.8 (0.05,10.11)	1.01 (0,6.51)	2.77 (0.06,15.95)	1.74 (0.02,10.62)	4 (0.16,21.4)	1.76 (0.02,10.63)	1.95 (0.05,11.19)	2.24 (0.05,12.62)	1.82 (0.08,9.53)	1.98 (0.07,10.56)	2.15 (0.02,13.25)	2.42 (0.07,13.38)	1.96 (0.02,11.99)	3.2 (0.03,19.75)	1.68 (0.08,8.62)	3.93 (0.11,21.65)	2.29 (0.1,11.82)	2.59 (0.01,17.35)	1
WM+Salvianolate	2.69 (0.36,10.05)	0.63 (0.06,2.64)	0.48 (0.05,1.93)	0.66 (0.04,3.14)	0.37 (0,2.28)	1.02 (0.05,5.14)	0.65 (0.01,3.63)	1.47 (0.14,6.06)	0.63 (0.02,3.51)	0.71 (0.04,3.45)	0.82 (0.04,3.95)	0.66 (0.07,2.69)	0.72 (0.06,3.1)	0.8 (0.02,4.54)	0.88 (0.06,3.94)	0.73 (0.02,4.07)	1.19 (0.03,6.74)	0.61 (0.08,2.32)	1.44 (0.09,6.7)	0.83 (0.09,3.26)	0.99 (0.01,6.26)	1.53 (0.03,8.85)	1

Note: ^aThe 95%CIs of the ORs did not contain 1.

Abbreviations: OR, odds ratio; CI, confidence interval; WM, conventional Western medical therapy; CKZ, Chuankezhi injection; DH, Danhong injection; DS, Danshen injection; DZXX, Dengzhanxixin injection; HH, Honghua injection; HJT, Hongjingtian injection; HQ, Huangqi injection; KA, Kangai injection; KDZ, Kudiezi injection; QKL, Qingkailing injection; RDN, Reduning injection; SF, Shenfu injection; SGM, Shengmai injection; SM, Shenmai injection; SHL, Shuanghuanglian injection; SXT, Shuxuetong injection; TRQ, Tanreqing injection; XYP, Xiyanping injection; XBJ, Xuebijing injection; XST, Xuesaitong injection; ZCL, Zhichuanling injection; Salvianolate, Salvianolate injection.

Table 3 The Results of Network Meta-analysis of FEV₁

MD (95%CI)	WM	WM+DZXX	WM+RDN	WM+SM	WM+SXN	WM+SXT	WM+TRQ	WM+XYP	WM+XBJ
WM	0
WM+DZXX	0.33 (−0.34, 1)	0
WM+RDN	0.31 (−0.12, 0.75)	−0.02 (−0.82, 0.78)	0
WM+SM	0.59 (0, 1.18)	0.26 (−0.63, 1.15)	0.28 (−0.46, 1.01)	0
WM+SXN	0.38 (−0.21, 0.97)	0.05 (−0.84, 0.94)	0.07 (−0.67, 0.8)	−0.21 (−1.05, 0.63)	0
WM+SXT	0.21 (−0.39, 0.81)	−0.12 (−1.02, 0.78)	−0.1 (−0.84, 0.64)	−0.38 (−1.22, 0.46)	−0.17 (−1.01, 0.67)	0
WM+TRQ	0.42 (0.22, 0.62)^a	0.09 (−0.61, 0.79)	0.11 (−0.37, 0.58)	−0.17 (−0.8, 0.45)	0.04 (−0.59, 0.66)	0.21 (−0.42, 0.84)	0
WM+XYP	0.25 (−0.17, 0.67)	−0.08 (−0.87, 0.71)	−0.06 (−0.67, 0.54)	−0.34 (−1.07, 0.39)	−0.13 (−0.86, 0.6)	0.04 (−0.69, 0.77)	−0.17 (−0.64, 0.3)	0
WM+XBJ	0.3 (−0.25, 0.85)	−0.03 (−0.9, 0.83)	−0.01 (−0.71, 0.69)	−0.29 (−1.1, 0.52)	−0.08 (−0.89, 0.73)	0.09 (−0.72, 0.9)	−0.12 (−0.67, 0.44)	0.05 (−0.65, 0.75)	0

Note: ^aThe 95%CIs of the MDs did not contain 0.

Abbreviations: MD, mean difference; CI, confidence interval; WM, conventional Western medical therapy; DZXX, Dengzhanxixin injection; RDN, Reduning injection; SM, Shenmai injection; SXN, Shuxuening injection; SXT, Shuxuetong injection; TRQ, Tanreqing injection; XYP, Xiyanping injection; XBJ, Xuebijing injection.

Table 4 The Results of Network Meta-analysis of FEV₁/FVC

MD (95%CI)	WM	WM+DH	WM+DZXX	WM+KA	WM+QKL	WM+RDN	WM+SF	WM+SXT	WM+TRQ	WM+XYP	WM+XBJ	WM+XST
WM	0
WM+DH	1.28 (−4.17, 6.75)	0
WM+DZXX	19.25 (9.15, 29.32)^a	17.96 (6.52, 29.43)^a	0
WM+KA	8.14 (0.24, 16.05)^a	6.86 (−2.74, 16.47)	−11.11 (−23.9, 1.71)	0
WM+QKL	3.07 (−5.44, 11.6)	1.79 (−8.33, 11.9)	−16.17 (−29.36, –2.95)^a	−5.07 (−16.68, 6.55)	0
WM+RDN	8.8 (4.41, 13.28)^a	7.52 (0.52, 14.57)^a	−10.44 (−21.4, 0.59)	0.66 (−8.36, 9.77)	5.73 (−3.82, 15.38)	0
WM+SF	3.89 (−1.93, 9.72)	2.61 (−5.36, 10.59)	−15.35 (−27, –3.7)^a	−4.25 (−14.05, 5.59)	0.82 (−9.49, 11.16)	−4.91 (−12.29, 2.36)	0
WM+SXT	2.74 (−5.37, 10.83)	1.46 (−8.31, 11.21)	−16.51 (−29.45, –3.55)^a	−5.4 (−16.74, 5.91)	−0.34 (−12.1, 11.4)	−6.07 (−15.36, 3.12)	−1.16 (−11.14, 8.82)	0
WM+TRQ	6.54 (3.84, 9.27)^a	5.26 (−0.82, 11.37)	−12.71 (−23.11, –2.25)^a	−1.6 (−9.94, 6.78)	3.47 (−5.44, 12.41)	−2.26 (−7.49, 2.92)	2.65 (−3.76, 9.1)	3.8 (−4.71, 12.38)	0
WM+XYP	2.86 (−3.04, 8.76)	1.58 (−6.44, 9.61)	−16.39 (−28.05, –4.71)^a	−5.28 (−15.14, 4.57)	−0.21 (−10.59, 10.13)	−5.94 (−13.37, 1.39)	−1.03 (−9.35, 7.28)	0.12 (−9.89, 10.14)	−3.68 (−10.19, 2.78)	0
WM+XBJ	4.44 (−0.56, 9.5)	3.16 (−4.22, 10.61)	−14.8 (−26.04, –3.52)^a	−3.7 (−13.03, 5.71)	1.37 (−8.49, 11.28)	−4.36 (−11.08, 2.32)	0.55 (−7.11, 8.27)	1.71 (−7.79, 11.26)	−2.1 (−7.8, 3.62)	1.59 (−6.12, 9.37)	0
WM+XST	8.1 (0, 16.2)	6.82 (−2.97, 16.59)	−11.15 (−24.05, 1.74)	−0.04 (−11.36, 11.25)	5.03 (−6.76, 16.76)	−0.7 (−9.99, 8.48)	4.21 (−5.79, 14.18)	5.36 (−6.1, 16.83)	1.56 (−7, 10.09)	5.24 (−4.8, 15.22)	3.66 (−5.93, 13.17)	0

Note: ^aThe 95%CIs of the MDs did not contain 0.

Abbreviations: MD, mean difference; CI, confidence interval; WM, conventional Western medical therapy; DH, Danhong injection; DZXX, Dengzhanxixin injection; KA, Kangai injection; QKL, Qingkailing injection; RDN, Reduning injection; SF, Shenfu injection; SXT, Shuxuetong injection; TRQ, Tanreqing injection; XYP, Xiyanping injection; XBJ, Xuebijing injection; XST, Xuesaitong injection.

Table 5 The Results of Network Meta-analysis of FEV₁%

MD (95%CI)	WM	WM+DH	WM+KA	WM+RDN	WM+SF	WM+SXT	WM+TRQ	WM+XYP	WM+XBJ	WM+XST
WM	0
WM+DH	3.8 (−2.16, 9.78)	0
WM+KA	5.58 (−2.87, 14.02)	1.78 (−8.57, 12.11)	0
WM+RDN	11.5 (6.57, 16.41)^a	7.7 (−0.06, 15.43)	5.92 (−3.85, 15.68)	0
WM+SF	5.74 (−0.57, 12.07)	1.94 (−6.75, 10.63)	0.17 (−10.38, 10.72)	−5.76 (−13.75, 2.26)	0
WM+SXT	6.8 (−2.08, 15.66)	3 (−7.71, 13.68)	1.22 (−11, 13.45)	−4.7 (−14.84, 5.43)	1.06 (−9.85, 11.94)	0
WM+TRQ	6.64 (2.58, 10.64)^a	2.84 (−4.4, 10.01)	1.07 (−8.32, 10.37)	−4.86 (−11.23, 1.47)	0.9 (−6.63, 8.36)	−0.15 (−9.92, 9.56)	0
WM+XYP	9.12 (2.57, 15.56)^a	5.32 (−3.57, 14.08)	3.55 (−7.18, 14.13)	−2.38 (−10.57, 5.72)	3.38 (−5.74, 12.39)	2.33 (−8.72, 13.25)	2.48 (−5.19, 10.09)	0
WM+XBJ	8.39 (2.91, 13.79)^a	4.59 (−3.55, 12.61)	2.82 (−7.29, 12.82)	−3.11 (−10.47, 4.18)	2.65 (−5.73, 10.94)	1.59 (−8.86, 11.95)	1.75 (−5.02, 8.51)	−0.73 (−9.19, 7.75)	0
WM+XST	7.59 (−1.01, 16.19)	3.78 (−6.69, 14.24)	2.01 (−10.03, 14.06)	−3.92 (−13.82, 6.02)	1.84 (−8.83, 12.52)	0.79 (−11.56, 13.16)	0.94 (−8.51, 10.48)	−1.54 (−12.25, 9.32)	−0.81 (−10.92, 9.42)	0

Note: ^aThe 95%CIs of the MDs did not contain 0.

Abbreviations: MD, mean difference; CI, confidence interval; WM, conventional Western medical therapy; DH, Danhong injection; KA, Kangai injection; RDN, Reduning injection; SF, Shenfu injection; SXT, Shuxuetong injection; TRQ, Tanreqing injection; XYP, Xiyanping injection; XBJ, Xuebijing injection; XST, Xuesaitong injection.

Table 6 The Results of Network Meta-analysis of Length of Hospital Stay

MD (95%CI)	WM	WM+HQ	WM+SGM	WM+SM	WM+TRQ	WM+XYP
WM	0
WM+HQ	−2.08 (−5.83, 1.67)	0
WM+SGM	−6.9 (−10.89, –2.9)^a	−4.82 (−10.28, 0.68)	0
WM+SM	−3.44 (−7.42, 0.55)	−1.36 (−6.82, 4.11)	3.46 (−2.21, 9.09)	0
WM+TRQ	−3.07 (−4.97, –1.15)^a	−0.99 (−5.18, 3.24)	3.83 (−0.61, 8.27)	0.37 (−4.03, 4.79)	0
WM+XYP	−3.4 (−8.03, 1.22)	−1.32 (−7.25, 4.61)	3.5 (−2.61, 9.59)	0.04 (−6.05, 6.13)	−0.33 (−5.35, 4.67)	0

Note: ^aThe 95%CIs of the MDs did not contain 0.

Abbreviations: MD, mean difference; CI, confidence interval; WM, conventional Western medical therapy; HQ, Huangqi injection; SGM, Shengmai injection; SM, Shenmai injection; TRQ, Tanreqing injection; XYP, Xiyanping injection.

Figure 4 Cluster analysis plot for outcomes ((A) Clinical efficacy and FEV₁ (B) Clinical efficacy and FEV₁/FVC (C) Clinical efficacy and FEV₁% (D) Clinical efficacy and length of hospital stay)).

Abbreviations: WM; conventional Western medical therapy; CKZ; Chuankezhi injection; DH; Danhong injection; DS; Danshen injection; DZXX; Dengzhanxixin injection; HH; Honghua injection; HJT; Hongjingtian injection; HQ; Huangqi injection; KA; Kangai injection; KDZ; Kudiezi injection; QKL; Qingkailing injection; RDN; Reduning injection; SF; Shenfu injection; SGM; Shengmai injection; SM; Shenmai injection; SHL; Shuanghuanglian injection; SXN; Shuxuening injection; SXT; Shuxuetong injection; TRQ; Tanreqing injection; XYP; Xiyanping injection; XBJ; Xuebijing injection; XST; Xuesaitong injection; ZCL; Zhichuanling injection; Salvianolate; Salvianolate injection.

Figure 5 Number and incidence of adverse reactions of the included interventions.

Abbreviations: WM; conventional Western medical therapy; CKZ; Chuankezhi injection; HQ; Huangqi injection; QKL; Qingkailing injection; RDN; Reduning injection; SF; Shenfu injection; SM; Shenmai injection; SHL; Shuanghuanglian injection; SXT; Shuxuetong injection; TRQ; Tanreqing injection; XYP; Xiyanping injection; XBJ; Xuebijing injection; XST; Xuesaitong injection.

Figure 6 Adverse reactions after WM alone and TCM injections plus WM.

Abbreviation: WM; conventional Western medical therapy.

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