Objective： This meta- analysis evaluated the efficacy and safety of Chinese herbal medicine （CHM） combined withangiotensin-converting enzyme inhibitors （ACEIs） and/or angiotensin-receptor blockers （ARBs）for tre...Objective： This meta- analysis evaluated the efficacy and safety of Chinese herbal medicine （CHM） combined withangiotensin-converting enzyme inhibitors （ACEIs） and/or angiotensin-receptor blockers （ARBs）for treatment ofincipient diabetic nephropathy（IDN）. Methods： Nine data bases were searched for randomized controlled trials ofChinese herbal medicine（CHM） and ACEI/ARB for treatment of IDN. Included articles were published betweenJanuary2006 and December 2016. All studies were divided into prescriptions containing both Astragali Radix andRehmanniae Radix （i subgroup）, Astragali Radix（Huangqi） or Rehmanniae Radix（Dihuang） （ii subgroup）, neitherAstragali Radix nor Rehmanniae Radix （iii subgroup）. Review Manager 5.3 was used for subgroup analysis.Results： In total, 28 RCTs with 2017 patients were included. The results showed 1）the urinary albumin excretionrate （UAER） can be reduced significantly using CHM with ACEI or ARB for treatment of IDN compared to ACEIor ARB alone, and reduction of the UAER of the i subgroup was superior to that of the other two subgroups;2）serum creatinine （Scr） levels can be reduced significantly using CHM combined with ACEI or ARB, andreduction of Scr in the ii subgroup was superior to that in the iii subgroup; 3）reduction of BUN in group A was notbetter than that in group B. Conclusion： In summary, CHMs combined with ACEI/ARB can decrease UAER andScr significantly compared to the use of ACEI/ARB during IDN treatment. The effect was more significant in theCHM group containing Astragali Radix or Rehmanniae Radix. The application of Astragali Radix and RehmanniaeRadix should be emphasized in third stage diabetic nephropathy.展开更多
Objective: To make a systematic assessment on whether the progression of early diabetic renal disease with normotension may be slowed down by angiotensin-converting enzyme (ACE) inhibitors. Methods: Randomized clinica...Objective: To make a systematic assessment on whether the progression of early diabetic renal disease with normotension may be slowed down by angiotensin-converting enzyme (ACE) inhibitors. Methods: Randomized clinical experiments published on MEDLINE from January 1990 to April 1999 and on China Biological Medicine were reviewed for studying the effects of ACE-inhibitors on normotensive patients with early diabetic renal diseases. Based on the inclusion criteria, 10 studies were selected. Their results were combined and analyzed with RevMan3. I software. Results: The pooled effect of urinary microalbumin excretion rate, systolic blood pressure, diastolic blood pressure and mean arterial blood pressure were -77.502 mg/24 h (-100.748 to-54.256), -5.002 mmHg [-9.630 to 0.685],-2.949 mmHg (-4.005 to 1.892). -4.284 mmHg (-5.444 to 3.123) respectively. Using clinical albuminuria as the end-point, the pooled odd ratio was 0.27 [95% CI 0.18 0.40]. The sub-group analysis showed that those results had no difference between type 1 and type 2 diabetes. There was no significant correlation between the pooled effects of urinary micro-albuminuria excretion rate and systolic blood pressure. diastolic blood pressure or mean arterial blood pressure. Conclusion: ACE inhibitors can decline urinary micro-albuminuria excretion rate in normotensive patients with early diabetic renal disease and delay the progression of early diabetic renal disease to clinical albuminuria. These effects may not be dependent on its blood pressure-reduction effect.展开更多
文摘Objective： This meta- analysis evaluated the efficacy and safety of Chinese herbal medicine （CHM） combined withangiotensin-converting enzyme inhibitors （ACEIs） and/or angiotensin-receptor blockers （ARBs）for treatment ofincipient diabetic nephropathy（IDN）. Methods： Nine data bases were searched for randomized controlled trials ofChinese herbal medicine（CHM） and ACEI/ARB for treatment of IDN. Included articles were published betweenJanuary2006 and December 2016. All studies were divided into prescriptions containing both Astragali Radix andRehmanniae Radix （i subgroup）, Astragali Radix（Huangqi） or Rehmanniae Radix（Dihuang） （ii subgroup）, neitherAstragali Radix nor Rehmanniae Radix （iii subgroup）. Review Manager 5.3 was used for subgroup analysis.Results： In total, 28 RCTs with 2017 patients were included. The results showed 1）the urinary albumin excretionrate （UAER） can be reduced significantly using CHM with ACEI or ARB for treatment of IDN compared to ACEIor ARB alone, and reduction of the UAER of the i subgroup was superior to that of the other two subgroups;2）serum creatinine （Scr） levels can be reduced significantly using CHM combined with ACEI or ARB, andreduction of Scr in the ii subgroup was superior to that in the iii subgroup; 3）reduction of BUN in group A was notbetter than that in group B. Conclusion： In summary, CHMs combined with ACEI/ARB can decrease UAER andScr significantly compared to the use of ACEI/ARB during IDN treatment. The effect was more significant in theCHM group containing Astragali Radix or Rehmanniae Radix. The application of Astragali Radix and RehmanniaeRadix should be emphasized in third stage diabetic nephropathy.
文摘Objective: To make a systematic assessment on whether the progression of early diabetic renal disease with normotension may be slowed down by angiotensin-converting enzyme (ACE) inhibitors. Methods: Randomized clinical experiments published on MEDLINE from January 1990 to April 1999 and on China Biological Medicine were reviewed for studying the effects of ACE-inhibitors on normotensive patients with early diabetic renal diseases. Based on the inclusion criteria, 10 studies were selected. Their results were combined and analyzed with RevMan3. I software. Results: The pooled effect of urinary microalbumin excretion rate, systolic blood pressure, diastolic blood pressure and mean arterial blood pressure were -77.502 mg/24 h (-100.748 to-54.256), -5.002 mmHg [-9.630 to 0.685],-2.949 mmHg (-4.005 to 1.892). -4.284 mmHg (-5.444 to 3.123) respectively. Using clinical albuminuria as the end-point, the pooled odd ratio was 0.27 [95% CI 0.18 0.40]. The sub-group analysis showed that those results had no difference between type 1 and type 2 diabetes. There was no significant correlation between the pooled effects of urinary micro-albuminuria excretion rate and systolic blood pressure. diastolic blood pressure or mean arterial blood pressure. Conclusion: ACE inhibitors can decline urinary micro-albuminuria excretion rate in normotensive patients with early diabetic renal disease and delay the progression of early diabetic renal disease to clinical albuminuria. These effects may not be dependent on its blood pressure-reduction effect.
