Background: Chinese herbs for supplementing qi and activating blood circulation combined with N-acetylcysteine (NAC) is widely used for idiopathic pulmonary fibrosis in China, but there is a lack of literature to evaluate its efficacy and clinical value.
Purpose: This study compared Chinese herb + NAC with other treatments by network meta-analysis to clarify its clinical value.
Methods: Cochrane Library, PubMed, Embase, Web of Science, China National Knowledge Infrastructure, WanFang Data, VIP Database, and China Biology Medicine were searched. Outcomes included lung function (DLCO (%), VC (%), FVC (%), FVC (L)), 6-min walking distance (6MWD), score of St George’s respiratory questionnaire (SGRQ), blood gas analysis (PaO2, PaCO2). The data were analyzed by Review Manager 5.4, Stata 12.0 and ADDIS 1.16.5.
Results: 23 studies including 1390 patients (702 in intervention group and 688 in control group) were collected to compare 8 outcome indicators among different treatments involving Chinese herb, Chinese herb+NAC, Chinese herb+PFD, NAC, PFD and PFD+NAC on pulmonary fibrosis. Network meta-analysis showed that Chinese herb was better than NAC in terms of DLCO (%) (MD = 5.14, 95%CI: 1.01 to 8.68) and 6MWD (MD = 49.17, 95%CI: 25.97 to 71.36) as well as PFD + NAC was better than NAC in terms of FVC (L) (MD = -0.56, 95%CI: -0.83 to -0.31).
In rankings results, Chinese herb + NAC is the best in terms of FVC (%), SGRQ, PaO2 and PaCO2; Chinese herb is the best in terms of DLCO (%), VC (%) and 6MWD; CH + PFD is the best in terms of FVC (L).
Conclusion: Chinese herb related treatments may have advantages in the treatment of pulmonary fibrosis and Chinese herb + NAC may have clinical application value.