中药保留灌肠联合美沙拉秦治疗溃疡性结肠炎的网状meta分析OA

Objective To systematically evaluate the efficacy and safety of eight Chinese herbal reten-tion enema regimens combined with mesalazine for ulcerative colitis(UC)using traditional and network meta-analysis.Methods Relevant randomized controlled trials(RCTs)were systematically retrieved from Chinese and English databases from inception to October 2025.Methodological quality was assessed using the Co-chrane Risk of Bias Tool.Statistical analyses were performed using StataMP14.0 and RevMan5.4.Results A total of 25 RCTs(2 013 patients)involving 8 Chinese herbal interventions were included.Network meta-anal-ysis showed that,in terms of overall clinical efficacy,Baitouweng Decoction,Shenling Baizhu Powder,Kang-fuxin Liquid,Xilei Powder,Qingbai Kuijie Decoction,and Qingchang Yuyang Decoction combined with me-salazine were all superior to mesalazine alone(P<0.05),with Qingbai Kuijie Decoction ranking highest by surface under the cumulative ranking curve(SUCRA).For serum IL-6 levels,traditional meta-analysis indica-ted that six combinations were effective(P<0.05),whereas network meta-analysis demonstrated that only Baitouweng Decoction,Kangfuxin Liquid,and Xilei Powder significantly reduced IL-6 levels(P<0.05),with Baitouweng Decoction ranking highest.For serum TNF-α levels,traditional meta-analysis showed six combi-nations effective(P<0.05),whereas network meta-analysis demonstrated that only Kangfuxin Liquid and Qingbai Kuijie Decoction significantly reduced TNF-α levels(P<0.05),with Kangfuxin Liquid ranking high-est.Regarding safety,only mild adverse events were reported,with no significant differences between groups(P>0.05).Conclusion Chinese herbal retention enema combined with mesalazine is more effective in alleviating clinical symptoms and improving inflammatory cytokine levels in UC patients,with a favorable safety profile.