Based on network Meta-analysis, we compared the effects of four traditional Chinese medicine(TCM) injections combined with conventional treatment on clinical total effective rate, recovery time of body temperature, cough disappearance time, lung rale disappearance time, wheezing relief time, and lung shadow disappearance time of bronchopneumonia in children and evaluated the safety of the four TCM injections in the treatment of bronchopneumonia in children, so as to provide an evidence-based basis for the clinical use of medication for bronchopneumonia in children. Computer retrieval was performed on CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, Web of Science, and Cochrane Library databases for randomized controlled trial(RCT) on the treatment of bronchopneumonia in children with TCM injections. The search time limit was from the establishment of each database to 2 January 2024. The relevant information of qualified literature was extracted, and data analysis was performed by using R 4.2.3 and Stata 15 softwares. The quality of the included studies was evaluated by the Cochrane risk of bias evaluation tool. Seventy RCTs were finally inclu-ded, with a total sample size of 8 629 cases, including 4 296 cases in experimental group and 4 333 cases in control group. The RCTs involved four TCM injections, namely Tanreqing Injection, Reduning Injection, Xiyanping Injection, and Yanhuning Injection. Network Meta-analysis showed that:(1) in terms of improving clinical total effective rate, surface under the cumulative ranking curve(SUCRA) ranking was Xiyanping Injection + conventional treatment > Tanreqing Injection + conventional treatment > Reduning Injection + conventional treatment > Yanhuning Injection + conventional treatment > conventional treatment.(2)In terms of shortening recovery time of body temperature, SUCRA ranking was Yanhuning Injection + conventional treatment > Xiyanping Injection + conventional treatment > Reduning Injection + conventional treatment > Tanreqing Injection + conventional treatment > conventional treatment.(3)In terms of shortening cough disappearance time, SUCRA ranking was Yanhuning Injection + conventional treatment > Xiyanping Injection + conventional treatment > Reduning Injection + conventional treatment > Tanreqing Injection + conventional treatment > conventional treatment.(4)In terms of shortening lung rale disappearance time, SUCRA ranking was Xiyanping Injection + conventional treatment > Reduning Injection + conventional treatment > Yanhuning Injection + conventional treatment > Tanreqing Injection + conventional treatment > conventional treatment.(5)In terms of shortening wheezing relief time, SUCRA ranking was Xiyanping Injection + conventional treatment > Tanreqing Injection + conventional treatment > Yanhuning Injection + conventional treatment > Reduning Injection + conventional treatment > conventional treatment.(6)In terms of shortening lung shadow disappearance time, SUCRA ranking was Reduning Injection + conventional treatment > Yanhuning Injection + conventional treatment > Tanreqing Injection + conventional treatment > Xiyanping Injection + conventional treatment > conventional treatment.(7)In terms of safety, 42 RCTs reported the occurrence of adverse reactions, mainly in the form of gastrointestinal reactions and skin rashes. Current evidence shows that the four TCM injections in combination with conventional treatment are all effective in treating bronchopneumonia in children to varying degrees. Xiyanping Injection + conventional treatment may be the most effective in improving clinical total effective rate, shortening lung rale disappearance time and wheezing relief time. Yanhuning Injection + conventional treatment may be the most effective in shortening recovery time of body temperature and cough disappearance time. Reduning Injection + conventional treatment may be the most effective in shortening lung shadow disappearance time. There were no serious adverse drug reactions during the treatment in both the experimental and control groups. Due to the limitations of the quality and quantity of the included literature, the above conclusions need to be further validated by more rigorously designed and high-quality RCT.
Keywords: bronchopneumonia in children; network Meta-analysis; traditional Chinese medicine injection.