Chinese patent medicines (CPMs), standardized herbal formulations widely used in clinical practice, combined with hormones have shown favorable therapeutic effects in the adjuvant treatment of endometriosis (EMS) after laparoscopic surgery. However, the optimal CPM option remains debatable. This network meta-analysis aimed to objectively compare the efficacy and safety of different CPM options for endometriosis after laparoscopic surgery.

Randomized controlled trials (RCTs) published up to June 2024 were searched in relevant databases. The risk of bias was assessed via the Cochrane bias risk assessment tool 2.0. The Bayesian network meta-analysis was conducted by R version 4.2.3 and STATA version 17.0.

A total of 47 RCTs were included. In terms of improving overall response rate, Guizhi Fuling pill combined with hormones was the most likely to be the best choice of CPM for endometriosis after laparoscopic surgery. Dan'e Fukang decoction had the best effect in improving the rate of pregnancy. Sanjie Zhentong capsule was the most effective in reducing the recurrence rate and estrogen (E2) levels. Xuefu Zhuyu capsule was the most effective in reducing the level of follicle-stimulating hormone (FSH) and the incidence of adverse reactions. Fuke Qianjin capsule was the most effective in reducing luteinizing hormone (LH) levels. Xiaojin capsule showed optimal efficacy in reducing serum carbohydrate antigen 125 (CA125) levels. None of the included studies reported serious adverse reactions.

CPMs can effectively improve overall response rate and reduce the incidence of adverse reactions after laparoscopic surgery for endometriosis. More high-quality, large-scale RCTs are required to validate the efficacy and safety of these CPMs.