Clinical effect of enriching qi, activating blood circulation, clearing away dampness and heat combined with western medicine in the treatment of idiopathic membranous nephropathy: A meta-analysis

Objective:To systemically review the efficacy and safety about the method of enriching qi,activating blood circulation,clearing away dampness and heat combined with western medicine in the therapy of patients with idiopathy membranous nephropathy(IMN).Methods:We collected the randomized controlled trials(RCTs)of enriching qi,activating blood circulation,clearing away dampness and heat for the treatment of IMN from Pub Med,The Cochrane Library,Medline,China National Knowledge Infrastructure(CNKI),China Biology Medicine disc(CBM),Wanfang Data and Wiper Databases.Bias of risk of retrieval literature was evaluated according to Cochrane Collaboration standard,and Review Manager 5.3 software was used for statistical analysis.Results:Fourteen trials(836 participants)were included in the meta-analysis.This kind of traditional Chinese method combined with western medicine in the treatment of IMN exerted statistical differences in reducing 24-hour urinary protein[WMD=-0.97,95%CI(-1.30,-0.65),Z=5.86(P<0.00001)]and elevating serum albumin[WMD=3.83,95%CI(2.10,5.57),Z=4.33,P<0.0001],lowering serum cholesterol[WMD=-0.82,95%CI(-1.08,-0.56),Z=6.18,P<0.00001],triglycerides[WMD=-0.39,95%CI(-0.67,-0.11),Z=2.77,P=0.006]and reducing the risk of adverse events[OR=0.29,95%CI[0.16,0.50],Z=4.35,P<0.0001]in the patients with IMN as compared with controls.However,there was no statistically significant difference between the method and controls when combining all trials in serum creatinine[WMD=-5.52,95%CI(-18.06,7.03),Z=0.86,P=0.39],when combining all trials in urea nitrogen[WMD=-0.90,95%CI(-2.22,0.41),Z=1.35,P=0.18].Conclusion:The method of enriching qi,activating blood circulation,clearing away dampness and heat combined with western medicine exerts certain advantages and better safety in treating patients with IMN.However,for the inferiority of the included studies,the conclusion still needs high-quality and large-sample prospective randomized controlled trials to verify.

Meta-Analysis of Niaoduqing Granules Combined With RAAS System Blocker in the Treatment of Diabetic Nephropathy

To systematically evaluate the efficacy of urinary granules combined with RAAS system blockers in the treatment of diabetic nephropathy(DN).A meta-analysis of the data required in the literature in accordance with this study was performed using Rev Man 5.3 software.Fifteen randomized controlled trials were analyzed in the present study to evaluate the clinical effect of Niaoduqing-angiotensin converting enzyme inhibitors/angiotensin receptor blocker(ACEI/ARB)in DN patients.A total of 1063 patients were involved,including 538 patients receiving the combination treatment and 525 patients in the control group.The results showed that the clinical efficacy of Niaoduqing granule combined with ACEI/ARB was significantly better than of the control group(odds ratio=2.92,95%confidence interval[CI]1.76–4.86).The treatment combined with Niaoduqing granule decreased the 24-h urinary protein quantitation(mean difference[MD]0.71,95%CI 0.28–1.14)and urine albumin excretion rate(UAER)(MD 41.13,95%CI 26.66–55.59)levels.However,the combination group had no treatment advantage on reducing serumurea nitrogen(MD 0.86,95%CI 0.05–1.68,P=0.02)and fasting blood glucose(MD-0.03,95%CI-0.15–0.09,P=0.61).And there was no significance in adverse events between two groups(risk ratio=2.34,95%CI 0.69–7.95,P=0.17).Niaoduqing granule-ACEI/ARB combination group maybe as safe as ACEI/ARB alone,and the combination played an advantage in improvement in total effective rate,reduction of 24-h urinary protein quantitation and UAER.