Meta Of Detoxification,Dredging Collaterals And Benefiting The Kidney In Treatment Of DKD And Mechanism Of Xiaoke Shen’an Decoction

Objectives:1 Through the Meta-analysis of the method of detoxification,dredging collaterals and benefiting the kidney in the treatment of diabetes kidney disease.To explore the clinical effectiveness of the method of detoxification,dredging collaterals and benefiting the kidney in the treatment of diabetes kidney disease,so as to provide a more objective evidence-based medical basis for clinical practice;2 Through the network pharmacology method,to explore the mechanism of Xiaoke Shen’an Decoction,which is based on the method of detoxification,dredging collaterals and benefiting the kidney,to learn more about the mechanism of Xiaoke Shen’an Decoction to protect the kidneys.Methods:1 According to the search strategy,retrieve the clinical research literature on the treatment of diabetes and kidney disease with detoxification,dredging collaterals and benefiting kidney in CNKI,Wanfang,VIP,Pub Med,and Cochrane Library databases method from the establishment of the database to December 2022.Then,extract and summarize the required data,and conduct Meta analysis through STATA14.2 TCMSP,Herb and other databases were used to collect the chemical constituents of Xiaoke Shen’an Decoction.The unretrieved hazel flowers were retrieved from CNKI and Wanfang databases,and the chemical constituents were collected by reading the literature.Import all the collected chemical components into the Swiss Target Prediction database to collect drug targets.Collect the disease targets of DKD in databases such as Gene Cards,OMIM,Drug Bank,etc.Use the venny diagram to obtain the intersection targets between Xiaoke Shen’an Decoction and DKD,then draw the "drugingredient-target" network diagram and protein interaction network(PPI).Finally use Metascape database for GO enrichment analysis and KEGG pathway Enrichment analysis.Results:1 A total of 1336 diabetic kidney disease patients were included in the 16 included literatures,including 688 cases in the treatment group and 648 cases in the control group.The results of Meta-analysis showed: Total efficiency(RR=1.29,95%CI[1.21,1.38],Z=8.5,P=0.000<0.05),24 h urinary protein quantification(SMD=-0.996,95%CI[-1.332,-0.661],Z=5.82,P=0.000<0.05),UAER(WMD=-23.401,95%CI[-28.139,-18.662],Z=9.68,P=0.000<0.05),serum creatinine(WMD=-0.616,95%CI[-0.959,-0.273],Z=3.52,P=0.000<0.05),glycosylated hemoglobin(WMD=-0.785,95%CI[-1.185,-0.385],Z=3.84,P=0.000<0.05).In all aspects,the method of detoxification,dredging collaterals and benefiting the kidney in the treatment of diabetic kidney disease was better than that in the control group.2 The mechanism of Xiaoke Shen’an Decoction was explored by network pharmacology method,collected a total of 184 chemical components,979 drug targets,1593 disease targets,and 229 intersection targets of Xiaoke Shen’an Decoction-DKD.Through analysis,quercetin,β-sitosterol,naringin,baicalein and other active components in the compound were found to combine with key targets such as ALB,TNF,IL6,AKT1,VEGFA and EGFR,act on multiple pathways such as HIF-1 signaling pathway,Rap1 signaling pathway,AGE-RAGE signaling pathway,PI3K-Akt signaling pathway and MAPK signaling pathway,to play a renal protective role.Conclusions:1 The total curative effect of detoxification,dredging collaterals and benefiting the kidney combined with western medicine group is better than that of the control group,and it can more effectively reduce the 24 h urine protein quantification,urine protein excretion rate,serum creatinine,and glycated hemoglobin levels.2 Xiaoke Shen’an Decoction with TNF,IL6,VEGFA,EGFR and other targets act on inflammatory pathways such as AGE-RAGE,Rap1,PI3K-Akt signaling pathways,inhibit the expression of inflammatory factors,and protect the kidneys.