Comparative Effectiveness of Chinese Patent Medicines for Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Bayesian Network Meta-Analysis

Objective: Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) presents with persistent pelvic pain, urinary symptoms, and psychological burden, severely affecting patients' quality of life. While antibiotics and α-blockers are commonly prescribed, their long-term efficacy is limited and adverse reactions are frequent. Chinese patent medicines (CPMs) have emerged as promising alternatives, yet the lack of head-to-head evidence among formulations hinders evidence-based clinical recommendations. Methods: Eight databases-CNKI, WanFang, VIP, SinoMed, PubMed, Web of Science, Embase, and the Cochrane Library-were searched from inception to November 1, 2025. Randomized controlled trials enrolling adults with CP/CPPS treated with CPMs versus standard therapy (ST) were included. Bias was assessed with ROB 2, and evidence certainty with CINeMA. A Bayesian network meta-analysis was performed, and outcomes were summarized using forest plots, league tables, and SUCRA curves in RStudio. Results: Seventy-six trials (n=8431) involving 12 CPMs were analyzed. All studies were conducted in China, and all CPMs outperformed ST in enhancing the total effective rate and reducing NIH-CPSI scores. Shuangshi Tonglin Capsules (SSTL) ranked highest for both overall efficacy (OR = 5.6; 95% CI [2.0, 17]; SUCRA 73.8%) and NIH-CPSI reduction (MD = -8.0; 95% CI [-11, -4.8]; SUCRA 93.3%). SSTL also provided the largest improvements in pain (MD = -5.4; 95% CI [-8.0, -2.8]) and quality of life (MD = -4.3; 95% CI [-5.7, -2.9]). Conclusion: Compared with ST, CPMs significantly improved CP/CPPS symptoms, with SSTL showing the greatest overall benefit. However, since all included studies originated from China, the generalizability of these findings to other populations may be limited.