BACKGROUND Ulcerative colitis (UC) is a chronic inflammatory disease with an increasing incidence in the world. Qingre-Chushi therapies (QC) can alleviate clinical symptoms. Therefore, a network meta-analysis was conducted to systematically evaluate the efficacy and safety of QC in the treatment of active UC patients. METHODS 7 databases were screened and relevant randomized controlled trials were selected. The tools of Cochrane Handbook and the GRADE system were conducted to assess the quality of outcomes. Pooled risk ratio or standard mean difference was calculated with 95% credible interval for outcomes measurement using the random-effects model. The surface under the cumulative ranking curve (SUCRA) was performed to rank the treatments. The larger SUCRA scores, the more effective interventions. RESULTS A total of 3560 articles were identified and 21 studies including 1829 participants were included for further analysis. Totally, 9 therapies regimens were compared: oral mesalazine, mesalazine enema, mesalazine suppository, oral mesalazine + mesalazine enema, oral QC, oral QC + oral mesalazine, QC enema, oral QC + QC enema, and oral mesalazine + QC enema. Based on the SUCRA plot, oral QC + oral mesalazine was the best treatment in inducing clinical response; oral QC + QC enema had the best efficacy in the improvement of Mayo scores and alleviating abdominal pain; oral mesalazine + mesalazine enema was the optimal therapy in the endoscopic improvement and reducing diarrhea; QC enema + oral mesalazine was the best option in preventing bloody stool. CONCLUSION This study confirmed the efficacy and safety of QC in treating active UC and suggested that the combination of oral medications with topical can achieve more benefits.

中文翻译：

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清热除湿疗法治疗活动性溃疡性结肠炎的疗效和安全性：网络荟萃分析。

背景技术溃疡性结肠炎(UC)是一种慢性炎症性疾病，在世界范围内发病率呈上升趋势。清热除湿疗法（QC）可以缓解临床症状。因此，进行网络荟萃分析以系统评估QC在治疗活动性UC患者中的有效性和安全性。方法筛选7个数据库，选取相关随机对照试验。使用 Cochrane 手册和 GRADE 系统的工具来评估结果的质量。使用随机效应模型以 95% 可信区间计算合并风险比或标准平均差，用于结果测量。进行累积排序曲线下的曲面 (SUCRA) 以对处理进行排序。SUCRA 分数越大，干预越有效。结果 共确定了 3560 篇文章，包括 1829 名参与者在内的 21 项研究被纳入进一步分析。共比较9种治疗方案：口服美沙拉秦、美沙拉秦灌肠、美沙拉秦栓剂、口服美沙拉秦+美沙拉秦灌肠、口服QC、口服QC+口服美沙拉秦、QC灌肠、口服QC+QC灌肠、口服美沙拉秦+QC灌肠。根据 SUCRA 图，口服 QC + 口服美沙拉嗪是诱导临床反应的最佳治疗方法；口服QC+QC灌肠在改善Mayo评分和减轻腹痛方面效果最好；口服美沙拉嗪+美沙拉嗪灌肠是改善内镜改善和减少腹泻的最佳疗法；QC灌肠+口服美沙拉秦是预防血便的最佳选择。