An Xiaoning, Xu Youhua, Gui Dingkun
Department of Nephrology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Faculty of Chinese Medicine, State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macao, China.
Evid Based Complement Alternat Med. 2023 Apr 17;2023:2945234. doi: 10.1155/2023/2945234. eCollection 2023.
This meta-analysis evaluated the curative effect of the compatibility of and (ARPN) as main components on diabetic nephropathy.
We used various Chinese and English databases, including the Cochrane Library, PubMed, Embase, Web of Science, the China National Knowledge Infrastructure (CNKI), China Biology Medicine Disc (SinoMed), VIP, and Wanfang, to search for randomized controlled trials on the compatibility of and as main components. After data extraction, meta-analysis was performed with Review Manager 5.4.0 and Stata 15, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework was used to evaluate the quality of the evidence.
A total of 17 studies involving 1342 patients with diabetic nephropathy were included. Compared with the control group, ARPN can significantly improve the clinical effective rate of diabetic nephropathy (OR 5.12, 95% CI 3.42 to 7.66, < 0.00001), and the curative effect of reducing UAER (MD -26.67, 95% CI -31.30 to -22.04, < 0.00001) and 24 h urinary protein (SMD -0.58, 95% CI -0.75 to -0.41, < 0.00001) is also significantly better than that of the control group, and it can also improve the renal function(Scr: MD -13.78, 95% CI -25.39 to -2.17, =0.02; BUN: MD -0.74, 95% CI -1.27 to -0.20, =0.007). In addition, it can also reduce glycosylated hemoglobin (SMD -1.30, 95% CI -2.33 to -0.27, =0.01) and blood lipid(TC: SMD -0.62, 95% CI -0.95 to -0.29, =0.0002; TG: SMD -0.47, 95% CI -0.75 to -0.19, =0.0009; LDL: SMD -0.43, 95% CI -0.68 to -0.18, =0.0008), and improve the TCM syndrome score (MD -4.87, 95% CI -6.17 to -3.57, < 0.00001). Subgroup analysis suggested that the treatment plan of the control group could be the sources of heterogeneity. All the included studies had no obvious adverse effects.
The compatibility of Radix Astragali and Radix notoginseng as the main components can effectively improve the renal function of patients with diabetic nephropathy and delay the progress of diabetic nephropathy. However, the results of this study need further research to be confirmed because of the uncertainty of the evidence and the suboptimal risk bias.
本荟萃分析评估以黄芪和三七为主要成分的配伍（黄芪三七配伍）对糖尿病肾病的疗效。
我们使用了多个中英文数据库，包括考克兰图书馆、PubMed、Embase、科学网、中国知网、中国生物医学文献数据库（SinoMed）、维普和万方，以检索关于以黄芪和三七为主要成分的配伍的随机对照试验。在数据提取后，使用Review Manager 5.4.0和Stata 15进行荟萃分析，并使用推荐分级的评估、制定和评价（GRADE）框架来评估证据质量。
共纳入17项研究，涉及1342例糖尿病肾病患者。与对照组相比，黄芪三七配伍能显著提高糖尿病肾病的临床有效率（OR = 5.12，95%CI为3.42至7.66，P < 0.00001），降低尿白蛋白排泄率（UAER）（MD = -26.67，95%CI为 -31.30至 -22.04，P < 0.00001）和24小时尿蛋白的疗效（SMD = -0.58，95%CI为 -0.75至 -0.41，P < 0.00001）也显著优于对照组，还能改善肾功能（血肌酐：MD = -13.78，95%CI为 -25.39至 -2.17，P = 0.02；血尿素氮：MD = -0.74，95%CI为 -1.27至 -0.20，P = 0.007）。此外，它还能降低糖化血红蛋白（SMD = -1.30，95%CI为 -2.33至 -0.27，P = 0.01）和血脂（总胆固醇：SMD = -0.62，95%CI为 -0.95至 -0.29，P = 0.0002；甘油三酯：SMD = -0.47，95%CI为 -0.75至 -0.19，P = 0.0009；低密度脂蛋白：SMD = -0.43，95%CI为 -0.68至 -0.18，P = 0.0008），并改善中医证候评分（MD = -4.87，95%CI为 -6.17至 -3.
