[Network Meta-analysis of traditional Chinese medicine injections combined with conventional western medicine for treatment of chronic obstructive pulmonary disease with respiratory failure].

This study aims to compare the efficacy and safety of different traditional Chinese medicine injections(TCMIs) combined with conventional western medicine in the treatment of chronic obstructive pulmonary disease(COPD) with respiratory failure(RF) using a network Meta-analysis approach. A comprehensive literature search was conducted in CNKI, VIP, Wanfang, SinoMed, Web of Science, PubMed, Cochrane Library, and EMbase databases from inception to June 29, 2025. Randomized controlled trials(RCTs) were performed by employing the literature on the treatment of COPD with RF by TCMIs, and data were analyzed by Stata 17. A total of 110 RCTs involving 9 218 participants and 11 different TCMIs were included. The ranking of efficacy in the surface under the cumulative ranking curve(SUCRA) from network Meta-analysis was as follows:(1) for improving clinical total response rate, Chuanxiongqin Injection + conventional western medicine, Shankezhi Injection + conventional western medicine, and Danhong Injection + conventional western medicine ranked top three;(2) for reducing mortality, Chuanxiongqin Injection + conventional western medicine, Danshen Chuanxiongqin Injection + conventional western medicine, and Shenfu Injection + conventional western medicine ranked top three;(3) for shortening length of hospital stay, Danshen Chuanxiongqin Injection + conventional western medicine, Shenfu Injection + conventional western medicine, and Shenmai Injection + conventional western medicine ranked top three;(4) for reducing duration of mechanical ventilation, Shenqi Fuzheng Injection + conventional western medicine, Shenmai Injection + conventional western medicine, and Tanreqing Injection + conventional western medicine ranked top three;(5) for improving arterial partial pressure of oxygen(PaO_2), Chuanxiongqin Injection + conventional western medicine, Danshen Injection + conventional western medicine, and Danhong Injection + conventional western medicine ranked top three;(6) for reducing arterial partial pressure of carbon dioxide(PaCO_2), Shenfu Injection + conventional western medicine, Tanreqing Injection + conventional western medicine, and Danshen Chuanxiongqin Injection + conventional western medicine ranked top three;(7) for improving arterial oxygen saturation(SaO_2), Shenqi Fuzheng Injection + conventional western medicine, Xuebijing Injection + conventional western medicine, and Xingnaojing Injection + conventional western medicine ranked top three;(8) for improving forced expiratory volume in one second(FEV_1), Chuanxiongqin Injection + conventional western medicine, Shenmai Injection + conventional western medicine, and Tanreqing Injection + conventional western medicine ranked top three;(9) for improving forced vital capacity(FVC), Danshen Chuanxiongqin Injection + conventional western medicine, Xuebijing Injection + conventional western medicine, and Tanreqing Injection + conventional western medicine ranked top three. In terms of safety, adverse events were mostly mild and occurred at a low incidence. In conclusion, TCMIs combined with conventional western medicine may offer clinical benefits in the management of COPD with RF. However, due to limitations in the number and quality of studies for each intervention, further rigorously designed RCT should be conducted to validate these findings.