Meta-analysis of clinical efficacy and safety of kidney Tonifying therapy in the treatment of interstitial lung disease

Objective:To evaluate the efficacy and safety of kidney tonifying therapy in the treatment of Interstitial Lung Disease(ILD).Methods:We searched Wanfang Data,CNKI,CBM,VIP,Pub Med,EMBASE,Web of science and Cochrane Library for Randomized Controlled Trials(RCTs)of kidney tonifying therapy in the treatment of ILD.The retrieval time was from the establishment of the database to December 15,2020.Rev man 5.3 software was used to analyze and summarize the collected literature,and the methodological quality of the included studies was evaluated by the bias risk assessment scale of Cochrane Collaboration Network.Results:A total of 15 articles with 1045 patients were included.The results of meta-analysis showed that compared with the control group treated with conventional western medicine alone,kidney tonifying therapy or combined with conventional western medicine was beneficial to improve the clinical total effective rate[RR=1.33(95%CI 1.24-1.43),P<0.00001].At the same time,compared with the control group treated with routine western medicine,kidney tonifying therapy or combined with routine western medicine can improve cough and wheezing symptoms of patients[MD=-0.62(95%CI-0.78~-0.46),P<0.00001]and MD=-0.79(95%CI-0.18~-0.49),P<0.00001].However,there was no significant improvement in 6-minute walk test and lung function(DLCO%)(P>0.05);only one study reported 7 patients with adverse reactions,but after corresponding treatment,the symptoms were significantly relieved.The analysis of the characteristics of intervention measures in the treatment group showed that there were a total of 80 traditional Chinese medicines involved,of which Shu Dihuang appeared the most frequently,and the tonic drugs were used the most.The two meridians of the lung and kidney appear most frequently.Among the four qi and five flavors,warm and sweet medicines have the highest frequency.Conclusion:Adopting kidney-tonifying method or combined with conventional Western medicine treatment can improve the total clinical effectiveness of patients.Adopting kidney-tonifying method or combined with conventional Western medicine treatment to improve symptoms such as coughing and wheezing.No serious adverse reactions have been reported,and the safety is reliable.Due to the low quality of the included literature,the results of this study need to be verified by high-quality,large sample randomized controlled trials.

Regulating and tonifying spleen and kidney traditional Chinese medicine in the treatment of chronic uric acid nephropathy: A systematic review

Objective:To systematically evaluate the efficacy and safety of traditional Chinese medicine for regulating spleen and kidney.Methods:We developed a search strategy and then retrieved the database including CNKI,Wanfang data knowledge service platform,VIP journals resource integration service platform,PubMed,Embasefor randomized controlled trial of regulating spleen and kidney traditional Chinese medicine compared with conventional western medicine in the treatment of chronic uric acid nephropathy.The search deadline was set to June 30,2020.For the included literature,we applied the cochrane collaboration network risk bias assessment tool to evaluate the methodological quality,and evaluated the level of evidence according to GRADE standards.Quantitative data was analyzed by RevMan5.3 software,and trial sequential analysis method was used to analyze its efficiency.Results:A total of 709 cases in 10 articles were included.Compared with the control group,the related traditional Chinese medicine group improved the effective rate[RR=1.45,95%CI(1.32,1.58)],reduced the level of UA[MD=-36.24,95%CI(-41.03,-31.45)],BUN[SMD=-1.27,95%CI(-1.47,-1.07)]and SCR[MD=-36.33,95%CI(-55.79,-16.87),P=0.0003],the difference between the two groups was statistically significant(P<0.05).There was no evidence that a significant adverse reaction occurred.The results of TSA analysis showed that the Chinese medicine group had definite evidence for improving the efficiency.According to the GRADE evaluation criteria,the efficiency,UA,BUN and SCR outcome indicators were extremely low-quality evidence.Conclusions:Traditional Chinese medicine for regulating spleen and kidney in the treatment of chronic uric acid nephropathy improved efficiency,reduced the level of UA,BUN,SCR.Meanwhile,the therapy was proved to be safe.Nevertheless,the conclusions need further high-quality evidence to support.

Controlled observation of posthemiplegic omalgia treated by acupuncture-moxibustion and rehabilitation

Objective To compare the efficacy difference between the acupuncture-moxibustion therapy for tonifying the primary and strengthening the shoulder and the rehabilitation therapy in the treatment of posthemiplegic omalgia （PO）. Methods Fifty-six cases of PO were randomized into an acupuncture-moxibustion group （30 cases） and a rehabilitation group （26 cases）. In the acupuncture-moxibustion group, the mild moxibustion with moxa stick was applied to Guānyuán （关元 CV 4）, Qìhǎi （气海 CV 6） and Zúsānlǐ （足三里 ST 36） and acupuncture was applied to Jiānzhēn （肩贞 SI 9）, Nàoshū （臑俞 SI 10）, Qūchí （曲池 LI 11）, etc. In the rehabilitation group, the conventional rehabilitation therapy was provided, including massaging local tissues, anti-cramping activity, etc. In both groups, the treatment was given once per day, 15 treatments made one session and two sessions were required totally. The visual analogue scale （VAS）, Fugl-Meyer assessment （FMA） and clinical neurologic impairment scale were adopted as the observation indicators for the evaluation of the analgesic effect and functional effect before and 30 days after treatment separately. Results The total analgesic effective rate was 100.0% （30/30） in the acupuncture-moxibustion group and was 96.2% （25/26） in the rehabilitation group, without presenting the statistical significant difference between two groups （P0.05）. VAS scores were all reduced significantly after treatment in both groups as compared with those before treatment （all P0.01）, but the comparison of the D-values before and after treatment did not reach the statistical significance between two groups （P0.05）. The scores of FMA and the clinical neurologic impairment scale were all improved significantly after treatment in both groups （all P0.01）. The improvements in the acupuncture-moxibustion group were superior to the rehabilitation group （all P0.01）. Conclusion Both therapies can achieve the analgesic effect on PO. The recovery of the motor and neurological functions after the impairment of the affected upper limb is superior in the treatment with the acupuncture and moxibustion therapy for tonifying the primary and strengthening the shoulder as compared with the rehabilitation therapy.