摘要Objective:To conduct a systematic review and network meta-analysis(NMA)for the comparison of the efficacy and safety of Chinese herbal injection(CHI)combined with Western medicine(WM)and WM monotherapy for chronic renal failure(CRF).Methods:Eight databases were searched from inception to August 30,2022.Randomized controlled trials(RCTs)regarding the comparison of CHI-WM combination therapy and WM monotherapy were included.Literature search,risk-of-bias assessment,and data extraction were conducted by 2 reviewers independently.NMA was performed by Stata 14.0,R 4.0.4 software,and the latest risk of bias assessment tool 2(RoB 2).Results:A total of 53 RCTs were finally included,involving 4445 participants and 16 CHIs.RoB 2 showed that 2 of these studies had a high risk of bias.Tianqi injection(TQ)+WM was the most effective in reducing serum creatinine(Scr)level.Xingding injection(XD)+WM was the most effective in reducing blood urea nitrogen(BUN)and cystatin C(Cys C)levels.Guhong injection(GH)+WM had the highest endogenous creatinine clearance rate(Ccr).Shuxuetong injection(SXT)+WM was the most effective in improving the clinical effective rate.Danhong injection(DH)+WM resulted in the lowest 24-h urinary protein quantity(24 h-UPQ),while Danshen injection(DS)+WM led to the lowest blood uric acid(UA)level.Shenfu injection(SF)+WM was the most effective in increasing hemoglobin(Hb)level.Conclusion:CHIs-WM combination therapy is more effective than WM monotherapy in treating CRF.Considering all of the indicators,SK+WM may be the optimal treatment option for improving renal function in patients with CRF.