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.