Effect Of Uremic Clearance Granule Combined With ACEI Or ARB In The Treatment Of Stage Ⅲ Diabetic Nephropathy:a Meta-analysis

Objective:We conducted a Meta-analysis to assess effect of UCG combined with ACEI or ARB in the treatment of stage Ⅲ Diabetic Nephropathy(DN),in order to provide it with evidence-based support.Methods:We collected label word concerning UCG and stage Ⅲ DN through screening product label、relevant Meta-analysis and other type studys published in nearly three years.Based on aim database search method in common,we searched and collected RCT form the Cochrane Library,Embase,PubMed,four mainland medicine databases(since each database builds the database to begin to search),and newest period of some relevant subject journals up to March 6th 2021,which bases a special study design of UCG combined with ACEI or ARB versus ACEI or ARB.Two evaluators who had received evidence-based training filtrated solely these studys abided by inclusion and exclusion criteria and collected these key message,and executed Meta-analysis in the application of STATA 12.0 and RevMan 5.3.Result:Our study included 11 trials that had happened in nine provinces of China,including 880 stage Ⅲ DN patients.The results showed that UCG group’s therapeutic rate is better than control group’s[RR=1.27,95%CI(1.17,1.37)](P<0.05).Some lab inditactors of UCG group improved better than control group,which include UAER[SMD=-1.08,95%CI(-1.24,-0.91)],Ccr[WMD=23.38,95%CI(12.85,33.91)],Scr[WMD=-7.28,95%CI(-10.19,-4.38),P<0.05],Cys-C[WMD=-0.45,95%CI(-0.64,0.25),P<0.05],HDL-C[WMD=0.27,95%CI(0.21,0.34)],TC[WMD=-0.93,95%CI(-1.09,-0.77)],TG [WMD=-0.66,95%CI(-1.12,-0.19)](P<0.05).Besides,there was no significant difference in the profit effects between UCG group and control group in BUN[WMD=-0.58,95%CI(-1.24,-0.08),P=0.085].The major type of ADR in the treatment of UCG combined with ACEI or ARB is diaherra.Conclusion:The treatment of UCG combined ACEI or ARB could reduce urinary protein and control stage Ⅲ DN multiple risk factors.Compared with ACEI or ARB solely,UCG combined with ACEI or ARB has advantages in elevating therapeutical rate,improving some DN damage indicators of UAER,Scr,Cys-C,TC,and TG,and improving DN protective indicators of HDL-C,Ccr,but no advantages in lowing BUN.The mechanism of how UCG cooperation treatment can get more profit needs further investigation.The treatment of UCG combined with ACEI or ARB couldn’t increase intrinsic ADR risk of the use solely of ACEI or ARB.Given this study has certain limitations,the benefit of UCG combined ACEI or ARB and its long-term effect need more design and careful,large sample,multicenter,long-term follow-up and standardized report RCT verified,which relevant clinical workers should do in the future.