Network Meta-analysis of Oral Kidney-tonifying Chinese Patent Medicine Combined with L-carnitine in the Treatment of Oligoasthenozoospermia

OBJECTIVE To evaluate the efficacy and safety of different kidney-tonifying Chinese patent medicines combined with L-carnitine(LC) in the treatment of oligoasthenozoospermia by network meta-analysis. METHODS Web of Science, Cochrane Library, EMbase, VIP, Wanfang, CNKI and Chinese Biomedical Literature Database were searched by computer for randomized controlled trials(RCTs) on related kidney-tonifying Chinese patent medicines combined with LC in the treatment of oligoasthenozoospermia. The retrieval time was from the establishment of the database to February 2022. Studies that met the quality criteria were analyzed using Stata 16.0 software and Review Manager 5.4. RESULTS A total of 2 820 articles were retrieved and finally 33 RCTs involving 8 Chinese patent medicines and 3 896 patients were included. The results of network meta-analysis showed that:eight Chinese patent medicines combined with LC were better than single use in improving each index. In terms of improving the total effective rate and sperm motility a% and (a+b)%, Qilin pill+LC had the best efficacy(SUCRA=90.9%, 90.4% and 98.0%). Fufang Xuanju capsule+LC had the best effect on improving sperm concentration and sperm survival rate(SUCRA=91.0%, 98.0%). In terms of safety, only 3 literatures reported the specific occurrence of adverse reactions, and no drug was discontinued due to adverse reactions. CONCLUSION Eight Chinese patent medicines combined with LC have good clinical efficacy in the treatment of oligoasthenozoospermia. Among them, Qilin pill+LC and Fufang Xuanju capsule+LC rank high and stable in all efficacy indicators, and have good clinical application value. Due to the lack of literature reporting adverse reactions, their safety remain to be further verified.