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

Shuai Lin,1,2,* Wenrui Huang,3,* Ruxin Liu,2 Juan Xu,2 Yanlin Li2 1Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Zhongshan, Guangdong, People’s Republic of China; 2Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, Guangdong, People’s Republic of China; 3Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, Guangdong, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yanlin Li, Email 20232120283@stu.gzucm.edu.cn Juan Xu, Email 260119441@qq.comObjective: 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.Keywords: chronic prostatitis, chronic pelvic pain syndrome, Chinese patent medicines, network meta-analysis