Chang Tian-Ying, Wang Hong-An, Wang Yin-Ping, Ma Jin-Hui, Zou Di, Zhang Shou-Lin, Thabane Lehana
EBM Department, The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun 130021, China.
Nephrology Department, The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun 130021, China.
Evid Based Complement Alternat Med. 2022 Dec 26;2022:6106993. doi: 10.1155/2022/6106993. eCollection 2022.
Traditional Chinese medicine (TCM) has a long history in the treatment of Immunoglobulin A nephropathy (IgAN). A large number of animal experiments focused on the TCM treatment of IgAN are conducted every year. The evidence for these preclinical studies is not clear. This study summarized and evaluated the results of animal experiments on TCM treatment for IgAN.
We systematically searched animal studies from 6 databases from inception to August 30, 2022. We included Chinese studies from the key magazine of China technology. The quality of the included studies was evaluated with the SYRCLE animal experimental bias risk assessment tool and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE).
Out of 832 records identified in the initial search, 30 studies were selected. The results indicated that, compared with the control group, the TCM treatment group improved 24 h urine protein (24 h-UP) level (standardized mean difference (SMD) 3.57, 95% confidence interval (CI) 4.48 to 2.66, < 0.001), urine red blood cell (U-RBC) (SMD 13.66, 95% CI 17.99 to 9.32, < 0.001), serum creatinine (Scr) (mean difference (MD) 10.89, 95% CI 17.00 to 4.77, < 0.001), blood urea nitrogen (BUN) (MD 2.44, 95% CI 3.42 to 1.47, < 0.001), tumor necrosis factor- (TNF-) (MD 171.28 to 95% CI 323.68 to 18.88, =0.03), transforming growth factor-1 (TGF-) (SMD 4.02, 95% CI 7.26 to 0.77, =0.02), matrix metalloproteinase-9/tissue inhibitors of metalloproteinase-1(MMP-9/TIMP-1) (MD 0.03, 95% CI 0.00 to 0.06, =0.02), nephrin mRNA (SMD 3.39, 95% CI 2.59 to 4.18, < 0.001). However, there is no difference in albumin level (MD 1.10, 95% CI 0.06 to 2.26, =0.06) and interleukin-6 (IL-6) (MD 170.77, 95% CI 365.3 to 23.75, =0.09).
TCM can improve 24 h-UP, U-RBC, Scr, BUN, MMP-9/TIMP-1, TNF-, TGF-, and nephrin mRNA of IgAN animal models. Moreover, there is a need for rigorous reporting of preclinical research methodology, which is essential to support the quality of preclinical research. . This review was registered with a systematic review record CRD42020171404 in the PROSPERO database.
中医在免疫球蛋白A肾病（IgAN）的治疗方面有着悠久的历史。每年都有大量聚焦于中医治疗IgAN的动物实验开展。这些临床前研究的证据尚不明确。本研究总结并评估了中医治疗IgAN的动物实验结果。
我们系统检索了从数据库建库至2022年8月30日的6个数据库中的动物研究。我们纳入了来自中国科技核心期刊的中文研究。采用SYRCLE动物实验偏倚风险评估工具和推荐分级的评估、制定与评价（GRADE）对纳入研究的质量进行评估。
在初步检索中识别出的832条记录中，筛选出30项研究。结果表明，与对照组相比，中医治疗组的24小时尿蛋白（24 h-UP）水平（标准化均数差（SMD）3.57，95%置信区间（CI）4.48至2.66，<0.001）、尿红细胞（U-RBC）（SMD 13.66，95%CI 17.99至9.32，<0.001）、血清肌酐（Scr）（均数差（MD）10.89，95%CI 1至4.77，<0.001）、血尿素氮（BUN）（MD 2.44，95%CI 3.42至1.47，<0.001）、肿瘤坏死因子-α（TNF-α）（MD 171.28至95%CI 323.68至18.88，P=0.03）、转化生长因子-β1（TGF-β1）（SMD 4.02，95%CI 7.26至0.77，P=0.02）、基质金属蛋白酶-9/金属蛋白酶组织抑制剂-1（MMP-9/TIMP-1）（MD 0.03，95%CI 0.00至0.06，P=0.02）、nephrin mRNA（SMD 3.39，95%CI 2.59至4.18，<0.001）均有所改善。然而，白蛋白水平（MD 1.10，95%CI 0.06至2.26，P=0.06）和白细胞介素-6（IL-6）（MD 170.77，95%CI 365.3至23.75，P=0.09）无差异。
中医可改善IgAN动物模型的24 h-UP、U-RBC、Scr、BUN、MMP-9/TIMP-1、TNF-α、TGF-β1和nephrin mRNA。此外，临床前研究方法需要严格报告，这对于支持临床前研究的质量至关重要。本综述已在PROSPERO数据库中注册为系统评价记录CRD420201714。
