Center of Clinical Evaluation, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China.
The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China.
Front Endocrinol (Lausanne). 2024 Jul 23;15:1400939. doi: 10.3389/fendo.2024.1400939. eCollection 2024.
To investigate the efficacy and safety of Shengjiang powder as a treatment for DKD.
A comprehensive search was performed in eight databases from their inception to December 30, 2023, to identify relevant RCTs. The inclusion criteria were diagnosis of DKD and intervention including TCM that contained Shengjiang powder. Two researchers independently conducted literature screening and data extraction, utilizing the Rob2 tool and GRADE to assess the quality of the RCTs. Meta-analysis was carried out using RevMan 5.4.1 and Stata 15.0.
As a result of the search, 23 RCTs comprising 1,682 patients. The interventions resulted in significant reductions in all the assessed indicators: 24-h urinary protein, UAER, mALB, BUN, Scr, FBG, 2hPG, HbA1c, total cholesterol, and Triglycerides. Together the results showed that Shengjiang powder, in conjunction with conventional therapy, is an effective treatment of DKD. Subgroup analyses, considering duration, stage, blood glucose control levels, baseline blood glucose levels, and baseline Scr levels indicated that shorter duration treatment had a greater effect on UAER, 2hPG, and HbA1c. Additionally, Shengjiang powder was more effective in reducing 24-h urinary protein, Scr, and 2hPG in stage IV patients compared to corresponding values at other stages. However, with respect to FBG, the treatment was more effective in stage II/III. Shengjiang powder also, reduced Scr levels significantly in patients with higher baseline Scr and reduced urinary protein excretion with stricter blood glucose control. The interventions had additional lipid-regulating effects in cases with looser blood glucose control and led to a remarkable reduction in BUN and Scr levels in patients with FBG > 11.1 mmol/L.
Shengjiang powder may supplement conventional therapy, thus benefiting DKD patients in terms of reducing urinary protein, stabilizing kidney function, and improving blood glucose and lipid metabolism. Considering the significant heterogeneity among studies and limited quality of some reports, our conclusions need to be further verified through analyses utilizing larger, multi-center samples of higher quality.
https://www.crd.york.ac.uk/prospero/, identifier CRD42024490795.
探讨升jiang 粉治疗 DKD 的疗效和安全性。
系统检索建库至 2023 年 12 月 30 日的八大数据库，纳入 TCM 中包含升 jiang 粉治疗 DKD 的随机对照试验（RCT）。两名研究者独立筛选文献和提取数据，采用 Rob2 工具和 GRADE 评估 RCT 质量，采用 RevMan 5.4.1 和 Stata 15.0 进行 Meta 分析。
共纳入 23 项 RCT，包含 1682 例患者。干预措施可显著降低所有评估指标：24 h 尿蛋白、UAER、mALB、BUN、Scr、FBG、2hPG、HbA1c、总胆固醇和三酰甘油。结果表明，升 jiang 粉联合常规治疗是 DKD 的有效治疗方法。亚组分析结果显示，治疗时间较短对 UAER、2hPG 和 HbA1c 的影响更大；在 IV 期患者中，升 jiang 粉降低 24 h 尿蛋白、Scr 和 2hPG 的效果优于其他分期；在 II/III 期患者中，升 jiang 粉降低 FBG 的效果更好；对于基线 Scr 较高和血糖控制更严格的患者，升 jiang 粉可降低 Scr 水平，增加尿蛋白排泄；对于血糖控制较宽松的患者，升 jiang 粉具有调脂作用，可显著降低 FBG＞11.1 mmol/L 患者的 BUN 和 Scr 水平。
升 jiang 粉可辅助常规治疗，减少 DKD 患者尿蛋白，稳定肾功能，改善血糖和血脂代谢。鉴于研究间存在显著异质性且部分报告质量有限，我们的结论还需通过更大样本、更高质量的多中心研究进一步验证。
https://www.crd.york.ac.uk/prospero/，注册号 CRD42024490795。
