Altern Ther Health Med. 2023 Nov;29(8):840-845.
Diabetic nephropathy (DN), also known as diabetic kidney disease (DKD), has caused enormous economic pressure and serious health problems worldwide. TCM practitioners commonly use a combination of Astragalus membranaceus (A. membranaceus) and Rhizoma Dioscoreae (R. Dioscoreae) in the treatment of DN. Research is still lacking on the therapeutic effects of TCM for DN.
The systematic review and meta-analysis intended to evaluate whether the combination of A. membranaceus and R. Dioscoreae together with Western medicine can provide better efficacy against DN than treatment with traditional Western medicine alone, to provide a clinical medical basis for the use of the TCM combination.
The research team performed a performed a systematic narrative review by searching the Web of Science, Science Direct, Pubmed, China National Knowledge Infrastructure (CNKI), VIP, Wanfang, Chinese Science and Technology Journal Database, and Biomedical Literature Chinese Database from databases' inceptions to May 2023. The team used the keywords astragalus and yam, diabetic nephropathy, antidiabetic, and 24-h urinary protein.
The review and meta-analysis occurred at Jiangxi Hospital of Integrated Traditional China and Western Medicine in Nanchang, Jiangxi, China.
To perform a subgroup analysis, the research team divided the studies into two groups based on the TCM treatment course, with one subgroup receiving treatment for ≤4 weeks and the second receiving treatment for >4 weeks, to judge whether a time-dependence existed for the effects of the TCM combination on UP.
All studies used 24-h urinary protein (UP) as the outcome measure.
In all studies, all heterogeneous (P < .01, I2 = 94%, the intervention groups had a significantly greater reduction in 24-h UP than the control groups did (P < .05). The heterogeneity for a treatment course of ≤4 weeks was P < .01, I2 = 97%, and for a course of >4 weeks was P < .01, I2 = 87%. For both ≤4 weeks and >4 weeks, the intervention groups had a significantly greater reduction in 24-h UP than the control groups did, with P < .01 and P < .01, respectively. The protein effect wasn't time dependent.
A. membranaceus and R. Dioscoreae can significantly reduce UP production, and inhibition of UP wasn't time-dependent.
糖尿病肾病（DN），又称糖尿病肾脏疾病（DKD），在全球范围内造成了巨大的经济压力和严重的健康问题。中医从业者通常将黄芪（A. membranaceus）和山药（R. Dioscoreae）联合使用来治疗 DN。关于中医治疗 DN 的疗效研究仍相对较少。
本系统评价和荟萃分析旨在评估黄芪和山药联合西药治疗是否比单纯使用传统西药治疗更能有效治疗 DN，为联合使用中药提供临床医学依据。
研究团队通过检索 Web of Science、Science Direct、Pubmed、中国知网（CNKI）、维普、万方、中国科技期刊数据库和中国生物医学文献数据库，从各数据库的建立到 2023 年 5 月进行了系统的叙述性综述。研究团队使用了黄芪和山药、糖尿病肾病、抗糖尿病和 24 小时尿蛋白等关键词。
该研究在江西中医药大学附属医院进行。
为了进行亚组分析，研究团队根据中医治疗疗程将研究分为两组，一组疗程≤4 周，另一组疗程>4 周，以判断中药联合用药对 UP 的疗效是否存在时间依赖性。
所有研究均使用 24 小时尿蛋白（UP）作为结局指标。
在所有研究中，所有异质性（P <.01，I2 = 94%），干预组的 24 小时 UP 降低显著大于对照组（P <.05）。疗程≤4 周的异质性为 P <.01，I2 = 97%，疗程>4 周的异质性为 P <.01，I2 = 87%。对于疗程≤4 周和>4 周，干预组的 24 小时 UP 降低均显著大于对照组（P <.01 和 P <.01）。蛋白效应与时间无关。
黄芪和山药可显著降低 UP 的产生，且抑制 UP 作用与时间无关。
