Clinical efficacy, safety, and cost of nine Chinese patent medicines combined with ACEI/ARB in the treatment of early diabetic kidney disease: A network meta-analysis

Objectives: To evaluate and compare the efficacy, safety, and cost of nine Chinese patent medicines (CPMs) combined with angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) in treating early diabetic kidney disease (DKD). Design: Systematic review and network meta-analysis. Data sources: PubMed, Embase, Cochrane Library, Web of Science, clinicaltrials.gov, SinoMed, Chinese Biomedicine, China National Knowledge Infrastructure, WanFang, and Chongqing VIP Information databases were comprehensively searched from the beginning to February 2022. Review Methods: Randomized controlled trials (RCTs) including Bailing capsule (BLC); Jinshuibao capsule (JSB); Huangkui capsule (HKC); Compound Xueshuantong capsule (CXC); uremic clearance granule (UCG); Shenyan Kangfu tablet (SYKFT); tripterygium glycosides (TG); Keluoxin capsule (KLX), and Shenshuaining tablet (SSNT) combined with ACEI/ARB for patients with early DKD were reviewed. Data Synthesis: Two reviewers independently screened articles, extracted data, and assessed the risk of bias. Risk ratios (RRs) and mean difference (MD) were reckoned to assess dichotomous variable quantities and continuous variable quantities, respectively. Using the surface under the cumulative ranking curve (SUCRA), we then ranked each therapeutic regime. Results: Ultimately, 160 RCTs involving 13,365 patients and nine CPMs were included. UCG showed significantly higher probabilities on urinary albumin excretion rate (UAER) when compared with ACEI/ARB group, with MD of −47 (95%CI) (−57, −37) and SUCRA 98.0%. The CXC group achieved a remarkable improvement in overall response rate (ORR) compared with ACEI/ARB (RR, 1.3, 95%CI (1.2, 1.5)) with SUCRA 91.9%. SSNT could be significantly superior to ACEI/ARB group in terms of serum creatinine (Scr) (−19 (−26, −12), SUCRA 99.3%) and adverse effects (AEs) (0.46 (0.17, 1.1), SUCRA 82.9%). BLC showed the greatest effectiveness on 24 h urinary total protein (24 h UTP) (−170 (−260, −83), SUCRA 78.5%) and triglyceride (Trig) (−0.89 (−1.2, −0.53), SUCRA 97.0%). From the cost-effectiveness analysis of CPMs in China, the cost of TG, SYKFT and CXC was 108, 600, and 648 RMB, respectively, per 3 months and were ranked in the top three. Conclusion: UCG and CXC might be the optimum selection for improving UAER and ORR, and SSNT could be significantly superior to ACEI/ARB group in terms of Scr and AEs. BLC shows the best curative effect on 24 h UTP and Trig. TG shows the highest cost-effectiveness among the nine CPMs.

Selection process 8 Specify the methods used to decide whether a study met the inclusion criteria of the review, including how many reviewers screened each record and each report retrieved, whether they worked independently, and if applicable, details of automation tools used in the process. 6 and Figure 1 Data collection process 9 Specify the methods used to collect data from reports, including how many reviewers collected data from each report, whether they worked independently, any processes for obtaining or confirming data from study investigators, and if applicable, details of automation tools used in the process.

5-7
Data items 10a List and define all outcomes for which data were sought. Specify whether all results that were compatible with each outcome domain in each study were sought (e.g. for all measures, time points, analyses), and if not, the methods used to decide which results to collect.

5-6
10b List and define all other variables for which data were sought (e.g. participant and intervention characteristics, funding sources). Describe any assumptions made about any missing or unclear information.

5-7
Study risk of bias assessment 11 Specify the methods used to assess risk of bias in the included studies, including details of the tool(s) used, how many reviewers assessed each study and whether they worked independently, and if applicable, details of automation tools used in the process.

and Supplementary
File 3 Effect measures 12 Specify for each outcome the effect measure(s) (e.g. risk ratio, mean difference) used in the synthesis or presentation of results. 7 Synthesis methods 13a Describe the processes used to decide which studies were eligible for each synthesis (e.g. tabulating the study intervention characteristics and comparing against the planned groups for each synthesis (item #5)).

6-7
13b Describe any methods required to prepare the data for presentation or synthesis, such as handling of missing summary statistics, or data conversions.

6-7
13c Describe any methods used to tabulate or visually display results of individual studies and syntheses.

6-7
13d Describe any methods used to synthesize results and provide a rationale for the choice(s). If meta-analysis was performed, describe the model(s), method(s) to identify the presence and extent of statistical heterogeneity, and software package(s) used.

6-7
13e Describe any methods used to explore possible causes of heterogeneity among study results (e.g. subgroup analysis, meta-regression). Supplementary  Table 1 13f Describe any sensitivity analyses conducted to assess robustness of the synthesized results.

Supplementary
File 4 Reporting bias assessment 14 Describe any methods used to assess risk of bias due to missing results in a synthesis (arising from reporting biases).

Supplementary
File 3 Certainty assessment 15 Describe any methods used to assess certainty (or confidence) in the body of evidence for an outcome. -

Study selection
16a Describe the results of the search and selection process, from the number of records identified in the search to the number of studies included in the review, ideally using a flow diagram. 8 and Figure 1 16b Cite studies that might appear to meet the inclusion criteria, but which were excluded, and explain why they were excluded.

and Supplementary
File 2 Study characteristics 17 Cite each included study and present its characteristics.   The trial only reported "randomized" No information was provided.

8-9 and Supplementary
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.
Unclear Dai X 2017 The trial used a random number-producing algorithm in central computer systems for simple randomization.
Allocation concealment was done by sealed sequentially numbered opaque envelopes. They were consecutively numbered and were provided to the patients according to the number allocated This article was a double-blind study Data were collected in a paper case report form and entered into a database.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Ding HH 2019
The trial only reported "randomized" No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Ding T 2014
Patients were randomly assigned to one of two treatment groups The subject numbers were assigned sequentially as each subject entered the study.
Both the patients, treating physicians, and individuals were blinded to patient treatment assignments.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Guan HB 2010
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

He XJ 2017
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.

Results of all primary outcomes
Unclear were reported.

Huang JY 2016
Patients were divided into one of two groups with the method of random sampling The person doing the randomization was blinded.
This article was a double-blind study.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Jiang T 2021
The trial only reported "randomized" No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Jin S 2018
The trial only reported "randomized" No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Jin XB 2016
Participants were randomly assigned following computer-based random numbers to one of the two treatment groups.
An analyst, without clinical involvement in the trial, kept randomization lists concealed.
Both the patients, treating physicians, and individuals were blinded to patient treatment assignments.
Data were collected in a paper case report form and entered into a database.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Lei SH 2009
The trial only reported "randomized" No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Li RN 2016
The trial only reported "randomized" No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Li YT 2014
The trial only reported "randomized" No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.

Results of all primary outcomes
Unclear were reported.

Li Z 2019
The trial only reported "randomized" No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Liang F 2015
Patients were randomly assigned to one of two treatment groups The subject numbers were assigned sequentially as each subject entered the study.
No information was provided.
Data were collected by an analyst, with no clinical involvement in the trial.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Liu CP 2011
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Liu JL 2015
The trial only reported "randomized" No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Liu WY 2017
Patients were randomly assigned to one of two treatment groups Allocation concealment was performed by enclosing assignments in sequentially numbered, opaque-closed envelopes.
The recruiting and treating doctors, as well as the patients, were blinded on the type of treatment throughout the medication period.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Luo F 2011
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Luo JG 2018
Patients were divided into one of two groups using random The person doing the randomization was blinded.
This article was a double-blind study No information was provided.
The trial did not report any Results of all primary Unclear number

Ma YL 2011
The trial only reported "randomized" No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Pan J 2016
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Qi MG 2016
The trial only reported "randomized" No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Qiu FP 2016
Patients were randomly assigned to one of two treatment groups Allocation concealment was performed by enclosing assignments in sequentially numbered envelopes.
Both the patients and treating physicians were blinded to patient treatment assignments.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Shen SM 2012
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Shen XY 2018
The trial only reported "randomized" No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Unclear
Shi GC 2014 Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any Results of all primary Unclear dropouts.
outcomes were reported.

Tang W 2017
Patients were divided into one of two groups using random number table method The author who performed the randomization did not participate in the enrolment and allocation of treatment to the participants and concealment was done using sequentially labeled sealed envelopes containing the specified intervention.
This article was a double-blind study Data were collected in a paper case report form and then entered into a database.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Wang FX 2009
Patients were divided into one of two groups using random number table method The person doing the randomization was blinded.
No information was provided.
Data were collected in a paper case report form and entered into a database.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Wang NN 2012
The trial only reported "randomized" No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Wang SY 2009
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Wang T 2019
The trial only reported "randomized" No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Wang XC 2010
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Wang YH 2008
The trial only reported "randomized" No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Unclear
Wei XF 2018 The trial used a random number-producing algorithm in central computer systems for simple randomization.
Allocation concealment was done by sealed sequentially numbered opaque envelopes.
The patients were masked in regards to active versus placebo assignment.
Data were collected in a paper case report form and entered into a database.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Unclear
Wei SJ 2010 The trial only reported "randomized" No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Unclear
Wu P 2021 Patients were divided into one of two groups using random number table method An analyst from a distant site, with no clinical involvement in the trial, kept randomization lists concealed.
This article was a double-blind study No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Wu QF 2016
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Wu L 2014
Patients were divided into one of two groups using random number table method The person doing the randomization was blinded.
This article was a double-blind study.
Data were collected in a paper case report form and entered into a database.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Xiao ZZ 2010
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Xu L 2015
The trial only reported "randomized" No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Yang CH 2013
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Yang G 2016
Patients were divided into one of two groups using random number table method Allocation concealment was done by sealed sequentially numbered opaque envelopes.
Both the patients, treating physicians, and individuals were blinded to patient treatment assignments.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Unclear
Yang WQ 2020 The trial only reported "randomized" No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Ye FL 2016
Patients were divided into one of two groups using random number table method The subject numbers were assigned sequentially as each subject entered the study.
No information was provided.
Data were collected in a paper case report form and entered into a database. Data assessors were blinded to treatment allocation.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Ye JB 2012
The trial only reported "randomized" No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.

Results of all primary outcomes
Unclear were reported.

Yu HT 2013
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Yun P 2013
The trial only reported "randomized" No information was provided.
No information was provided.
No information was provided.
Five cases were withdrawn from the trial after losing follow-up Results of all primary outcomes were reported.

Zhang C 2014
Patients were randomly assigned to one of two treatment groups Allocation concealment was done by sealed sequentially numbered opaque envelopes.
The patients were masked in regards to active versus placebo assignment.
No information was provided.
Three cases were withdrawn from the trial after losing follow-up Results of all primary outcomes were reported.

Zhou J 2012
The trial only reported "randomized" No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Zhou XJ 2016
The trial only reported "randomized" No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Zhu HY 2015
The trial used a random number-producing algorithm in central computer systems for simple randomization.
The author who performed the randomization did not participate in the enrolment The patients were masked in regards to active versus placebo assignment Data were collected in a paper case report form and entered into a database.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Cai JY 2010
Patients were divided into one of two groups using random number table method Allocation concealment was performed by enclosing assignments in sequentially numbered, opaque-closed envelopes.
This article was a double-blind study.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Cai XY 2010
The trial only reported "randomized" No information was provided.
Using single blind randomization No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Cao XC 2015
Patients were divided into one of two groups using random number table method The person doing the randomization was blinded.
The recruiting and treating doctors, as well as the patients, were blinded on the type of treatment throughout the medication period.
Data were collected in a paper case report form and entered into a database.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Cao XX 2017
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Cao YX 2019
The trial only reported "randomized" No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Chen F 2010
The trial only reported "randomized" No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Chen QS 2016
Patients were randomly assigned to one of two treatment groups The author who performed the randomization did not participate in the enrolment This article was a double-blind study.
Data were collected in a paper case report form and entered into a database. Data The trial did not report any dropouts.
Results of all primary outcomes were Unclear assessors were blinded to treatment allocation. reported.

Chen QJ 2017
The trial only reported "randomized" No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Unclear
Chen SS 2020 Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Chen SW 2018
Patients were randomly assigned to one of two treatment groups The author who performed the randomization did not participate in the enrolment Both the patients, treating physicians, and individuals were blinded to patient treatment assignments.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Chen Y 2020
The trial only reported "randomized" No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Chen Y 2015
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Chi PW 2012
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Dai XM 2012
Random grouping method is not mentioned in the trial The subject numbers were assigned sequentially as each subject entered the study.
No information was provided.
Data were collected in a paper case report form and entered into a database.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Deng SY 2014
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Deng SY 2016
Patients were randomly assigned to one of two treatment groups The person doing the randomization was blinded.
This article was a double-blind study.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Dou JF 2006
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Fan YT 2015
The trial only reported "randomized" No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Feng ZL 2017
Patients were randomly assigned to one of two treatment groups The person doing the randomization was blinded.
This article was a double-blind study.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Gao X 2018
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Ge QR 2011
Patients were divided into one of two groups using random number table method Allocation concealment was done by sealed sequentially numbered opaque envelopes. They were consecutively numbered and bottles were provided to the patients according to the number allocated The patients were masked in regards to treatment versus placebo assignment, but the physicians were not for safety reasons and because the end points were objective and measured centrally by a lab blinded to patient designation.
Data were collected in a paper case report form and entered into a database. Data assessors were blinded to treatment allocation.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Gu RY 2018
The trial only reported "randomized" No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Unclear
Guan YH 2020 Patients were grouping according to medication regimen No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Unclear
Guan CA 2021 Using random number table The author who performed the randomization did not participate in the enrolment This article was a double-blind study.
Data were collected in a paper case report form and entered into a database.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Guo G 2015
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Guo T 2016
Patients were grouping according to medication regimen No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were Unclear reported.
He P 2012 Using random number table The person doing the randomization was blinded.
This article was a double-blind study.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

He XH 2012
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

He YY 2021
Patients were divided into one of two groups using random number table method The subject numbers were assigned sequentially as each subject entered the study.
This article was a double-blind study.
Data were collected in a paper case report form and entered into a database.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

He YN 2010
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Hu QS 2007
Patients were semi-randomly divided into one of two treatment groups The person doing the randomization was blinded.
Using single blind semi random grouping No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Hu WF 2012
Patients were randomly assigned to one of two treatment groups No information was provided. No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Hu XJ 2019
Patients were divided into one of two groups using random number table method The author who performed the randomization did not participate in the enrolment Both the patients, treating physicians, and individuals were blinded to patient treatment assignments.
Data were collected in a paper case report form and entered into a database.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Hu YG 2016
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Hu Y 2016
Patients were divided into one of two groups using random number table method Allocation concealment was performed by enclosing assignments in sequentially numbered, opaque-closed envelopes.
This article was a double-blind study.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Huang T 2010
Patients were divided into one of two groups using random number table method The person doing the randomization was blinded.
Both the patients, treating physicians, and individuals were blinded to patient treatment assignments.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Jia ZW 2015
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Xie WY 2019
Patients were grouping according to medication regimen No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Lan YL 2021
Patients were divided into one of two groups using random number table method Allocation concealment was done by sealed sequentially numbered opaque envelopes.
The patients were masked in regards to active versus placebo No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Li HJ 2013
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Li BY 2015
Patients were divided into one of two groups using random number table method The subject numbers were assigned sequentially as each subject entered the study.
This article was a double-blind study.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Li HS 2017
Using random sequential comprehensive equilibrium method The author who performed the randomization did not participate in the enrolment The recruiting and treating doctors, as well as the patients, were blinded on the type of treatment throughout the medication period.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Li HN 2022
Patients were grouping according to medication regimen No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Unclear
Li Q 2020 Dividing into groups according to the number of people No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Unclear
Li Q 2021 Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Li QH 2010
The trial used a random number-producing algorithm in central computer systems for simple Allocation concealment was performed by enclosing assignments in sequentially numbered, opaque-closed This article was a double-blind study.
Data were collected in a paper case report form and entered into a database.
The trial did not report any dropouts.
Results of all primary outcomes were Unclear randomization.

Li YN 2013
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Liang YP 2014
Patients were randomly assigned to one of two treatment groups The subject numbers were assigned sequentially as each subject entered the study.
This article was a double-blind study.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Lin M 2013
The trial only reported "randomized" No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Lin M 2011
Patients were semi-randomly divided into one of two treatment groups No information was provided. Using single blind random grouping No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Lin ZN 2016
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Liu CP 2011
Patients were divided into one of two groups using random number table method The person doing the randomization was blinded.
Both the patients, treating physicians, and individuals were blinded to patient treatment assignments.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Liu L 2021
Patients were randomly assigned to one of two treatment groups The subject numbers were assigned sequentially as each subject entered the study.
This article was a double-blind study.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Liu L 2012
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Liu XQ 2012
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Liu XD 2011
Patients were randomly assigned to one of two treatment groups The person doing the randomization was blinded.
This article was a double-blind study.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Liu YP 2018
Patients were randomly assigned to one of two treatment groups The author who performed the randomization did not participate in the enrolment Both the patients, treating physicians, and individuals were blinded to patient treatment assignments.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Liu YH 2011
Random grouping method is not mentioned in the trial No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Lou PH 2010
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Luo JJ 2021
The trial used a random number-producing algorithm in central computer systems for simple randomization.
Allocation concealment was done by sealed sequentially numbered opaque envelopes.
The recruiting and treating doctors, as well as the patients, were blinded on the type of treatment No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Unclear
Lv F 2012 Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Lv MF 2015
Random grouping method is not mentioned in the trial No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Nie XY 2018
Patients were divided into one of two groups using random number table method Allocation concealment was performed by enclosing assignments in sequentially numbered, opaque-closed envelopes.
Both the patients, treating physicians, and individuals were blinded to patient treatment assignments.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Ou YL 2015
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Pan CY 2016
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Qi JY 2018
Patients were randomly assigned to one of two treatment groups The person doing the randomization was blinded.
This article was a double-blind study.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Qiao AM 2013
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Ren X 2020
Patients were divided into one of two groups using random number table method The author who performed the randomization did not participate in the enrolment and allocation of treatment to the participants and concealment was done using sequentially labeled sealed envelopes This article was a double-blind study.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Shen ML 2015
Random according to the order of admission No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Su JF 2019
Patients were divided into one of two groups using random number table method The subject numbers were assigned sequentially as each subject entered the study.
The recruiting and treating doctors, as well as the patients, were blinded on the type of treatment No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Sun FY 2021
Patients were divided into one of two groups using random number table method The person doing the randomization was blinded.
This article was a double-blind study No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Sun JY 2015
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Sun SR 2014
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.

Results of all primary outcomes
Unclear were reported.

Tang YZ 2011
Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Tian XY 2019
Patients were divided into one of two groups using random number table method Allocation concealment was done by sealed sequentially numbered opaque envelopes.
This article was a double-blind study.
Data were collected in a paper case report form and entered into a database and data assessors were blinded to treatment allocation.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Unclear
Wang AY 2020 Patients were randomly assigned to one of two treatment groups No information was provided.
No information was provided.
No information was provided.
The trial did not report any dropouts.
Results of all primary outcomes were reported.

Wang G 2006
Patients were divided into one of two groups using random number table method Allocation concealment was performed by enclosing assignments in sequentially numbered, opaque-closed envelopes.
Both the patients, treating physicians, and individuals were blinded to patient treatment assignments.