Meta-analysis of the efficacy and safety of Shenkang injection combined with Western medicine in the treatment of chronic glomerulonephritis

Objective:The purpose of the research was to systematically evaluate the clinical efficacy and safety of Shenkang injection combined with Western medicine in treating chronic glomerulonephritis.Methods:Randomized controlled trials of Shenkang Injection combined with Western medicine in treating CGN were obtained from 8 Science databases including China National Knowledge Infrastructure(CNKI),China Biomedical Database(SinMed),Weipu Database(VIP),Wanfang Database(Wanfang),PubMed,The Cochrane Library,Embase,Web of Science from establishment to June 2022.Two researchers screened literature and extracted useful data according to inclusion and exclusion criteria,and used RevMan 5.3 and STATA SE 14.0 software to perform meta-analysis.Results:1,214 patients were included in 15 studies,with 607 in treatment group and 607 in control group.The results of meta-analysis showed that the treatment group could improve the clinical effective rate[RR=1.33,95%CI(1.25,1.40),P<0.00001],reduce serum creatinine[MD=-31.28,95%CI(-42.90,-19.66),P<0.00001],blood urea nitrogen[MD=-2.26,95%CI(-3.08,-1.44),P<0.00001],24-hour urine protein quantification[MD=-0.37,95%CI(-0.49,-0.25),P<0.00001],tumor necrosis factor-α[MD=-7.93,95%CI(-10.56,-5.30),P<0.00001],systolic blood pressure[MD=-10.81,95%CI(-13.66,-7.96),P<0.00001]and diastolic blood pressure[MD=-7.36,95%CI(-9.34,-5.38),P<0.00001].Conclusion:Shenkang injection combined with Western medicine can enhance the clinical effective rate of CGN and reduce the levels of serum creatinine,blood urea nitrogen,24-hour urine protein quantification,tumor necrosis factor-α,systolic blood and diastolic blood pressure.However,due to the low quality of literature,the conclusion still needs to be supported by more multi-center,large-sample studies with rigorous design and standardized implementation.

Shenkang Injection protects against diabetic nephropathy in streptozotocin(STZ)-induced mice through enhancement of anti-oxidant and anti-inflammatory activities

Objective:To investigate the protective effects and possible mechanisms of Shenkang Injection(SKI)on the diabetic nephropathy in streptozotocin-induced mice.Methods:STZ with the feeding of high fat diet(HFD)was used to induce diabetic mice.The balb/c mice and diabetic mice were then randomly divided into five groups:(1)control group,(2)model group,(3)alprostadil(Alp,1.5μg/kg)group,(4)SKI(30 ml/kg)group,(5)Alp(1.5μg/kg)+SKI(15 ml/kg)group.After six weeks'treatment,blood,urine and kidney tissues were collected for biochemical assay,EUSA assay,and pathological analysis.Results:Diabetic mice exhibited evident manifestations of diabetic nephropathy(DN),as indicated by increased 24-h urine volume,urinary albumin and kidney weight index(P<0.01),which could be attenuated by SKI treatment(P<0.01).SKI was further found to improve abnormal morphology in glomerulus with increased glomerular volume and to decrease urinary N-acetyl-b-D-glucpsaminidase(NAG),β2-microglobulin(β2-MG),and kidney injury molecules-1(KIM-1)levels(P<0.05,P<0.01).Plasma levels of anti-oxidant enzymes significantly reduced in the diabetic mice,and those decreases could be reversed by SKI and Alp treatments.Additionally,SKI obviously suppressed the diabetes-induced increases of proinflammatory cytokines(IL-6,IL-1βand TNF-α)(P<0.01).Meanwhile,SKI was found to effectively attenuate the diabetes-induced coagulation dysfunction,as evidenced by lengthening prothrombin and thrombin time,and decreasing plasma levels of fibrinogen(FIB),6-K-PGF1αand thromboxane B2(TXB2)(P<0.05,P<0.01).With SKI and Alp combined treatment,the anti-oxidant activities and improvements of coagulation dysfunction were enhanced.Conclusion:SKI possesses a remarkable property to prevent diabetic nephropathy.The improvements of kidney function and hypercoagulability by SKI were enhanced with Alp combined treatment.The molecular mechanisms underlying the protection of SKI against DN may be related to enhancing the antioxidant and anti-inflammatory activities,and improving the coagulation dysfunction.