Meta-analysis of the correlation between diabetic nephropathy and inflammatory response based on Shenqi Dihuang Decoction

Objective:A meta-analysis was used to systematically study the correlation between inflammatory response and diabetic nephropathy based on Shenqi Dihuang Decoction.Methods:The RCT literatures related to the efficacy and inflammatory response of Shenqi Dihuang Decoction in the treatment of diabetic nephropathy in Chinese and English databases were searched.The time limit was from the establishment of the database to February 2020.Literature screening and data extraction were performed according to the criteria for inclusion and exclusion.The evaluator's manual 5.1.0 was used to evaluate the risk of bias in the final included literature.Meta-analysis was performed using RevMan 5.3 software.Comparing western medicine treatment and Shenqi Dihuang decoction to inflammatory factors:interleukin-6(IL-6)Interleukin-8(IL-8),tumor necrosis factor-α(TNF-α),C-reactiveprotein(CRP),intercellular adhesion molecule-1(MCP-1),and monocyte chemotactic protein-1(ICAM-1)and efficacy indicators:the impact of urine microalbumin(mALB)and clinical efficacy.Results:A total of 11 related research reports were finally included,of which 9 evaluated IL-6[SMD=-1.09,95%CI(-1.57,-0.61),Z=4.43,P<0.00001];5 Item evaluated IL-8[SMD=-0.91,95%CI(-1.44,-0.37),Z=3.33,P=0.0009<0.05];7 items evaluated TNF-[SMD=-0.97,95%CI(-1.49,-0.45),Z=3.63,P=0.0003<0.05];9 items evaluated CRP[SMD=-1.40,95%CI(-1.89,-0.90),Z=5.49,P<0.00001];2 items evaluated MCP-1[SMD=-0.71,95%CI(-1.00,-0.43),Z=4.95,P<0.00001];1 item was ICAM-1 Evaluation was performed[SMD=-0.98,95%CI(-1.38,-0.58),Z=4.82,P<0.00001];6 items used mALB as the efficacy index[SMD=-1.85,95%CI(-2.65,-1.05),Z=4.52,P<0.00001];9 items evaluated the clinical efficacy,[OR=4.45,95%CI(2.96,6.69),Z=7.17,P<0.00001].Conclusion:Shenqi Dihuang Decoction was used in patients with diabetic nephropathy.Compared with the western medicine treatment group,the levels of IL-6,IL-8,TNF-α,CRP,MCP-1,ICAM-1and inflammatory factors were significantly reduced.The effect is significantly increased.It is suggested that Shenqi Dihuang Decoction has better anti-inflammatory response than diabetic nephropathy than western medicine alone.