A Systematic Review And Analysis Of Medication Rules For Improving The Inflammatory Response Of Early Diabetic Nephropathy With Traditional Chinese Medicin

Purpose:The method based on Meta-analysis systematically evaluates traditional Chinese medicine to improve the inflammatory response of early Diabetic kidney disease,and explores the regularity of its prescription and medication,which provides a theoretical basis for the early treatment of Diabetic kidney disease in the future.Material and method:Search CNKI,Wanfang,VIP,Pub Med,Embase and other major databases,and the search time is set from the establishment of each database to December 2021.To search for clinical RCT studies of traditional Chinese medicine improving inflammatory response in early Diabetic kidney disease.Meta-analysis was performed using Review Manager 5.4 software.The main observation indexes included:IL-6,hs-CRP,TNF-α;the secondary observation indexes included:UAER,UACR,B UN,Scr,FPG,2h PG,Hb Alc,TG,TC,LDL-C,HDL-C,total effective rate,etc.Using the traditional Chinese medicine inheritance auxiliary platform V3.0 to analyze the m edication rules,including drug frequency,attribute statistics,association analysis,cluster analysis,etc.,to explore the core medication rules of traditional Chinese medicine to improve the inflammatory response of early Diabetic kidney disease.Results:1 Meta analysis results(1)Finally,40 RCT studies that met the inclusion criteria were screened,including a total of 3639 test patients;(2)The improvement of the inflammatory response of early DKD patients by traditional Chinese medicine was significantly better than that of the control group,IL-6:[SMD=-1.25,95%CI(-1.52,-0.99),Z=9.19(P<0.00001)];hs-CRP:[MD=-1.62,95%CI(-1.92,-1.31),Z=10.32(P<0.00001)]0.00001)];TNF-α:[SMD=-1.39,95%CI(-1.60,-1.17),Z=12.78(P<0.00001)];(3)Traditional Chinese medicine was significantly better in improving renal function in patients with early D KD.In the control group,UAER:[SMD=-1.35,95%CI(-1.68,-1.02),P<0.00001];UA CR:[SMD=-1.91,95%CI(-2.72,-1.10),P<0.00001];BUN:[SMD=-0.81,95%CI(-1.19,-0.42),P<0.0001];Scr:[SMD=-0.50,95%CI(-0.68,-0.32),P<0.00001];(4)The im provement of blood sugar in early DKD patients by traditional Chinese medicine was significantly better than that in the control group,FPG:[MD=-0.43,95%CI(-0.65,-0.21),P<0.0001];2h PG:[MD=-0.67,95%CI(-1.02,-0.32),P=0.0002];Hb A1c:[MD=-0.39,95%CI(-0.71,-0.07),P=0.02];(5)The effect of traditional Chinese medicine on patients with early DKD The improvement of blood lipids was significantly better than that of the control group,TG:[MD=-0.33,95%CI(-0.49,-0.18),P<0.0001];TC:[MD=-0.39,95%CI(-0.53,-0.25),P<0.00001];LDL-C:[MD=-0.27,95%CI(-0.39,-0.15),P<0.00001];HDL-C:[MD=0.09,95%CI(0.05,0.13]),P<0.00001].(6)The total clinical effective rate of traditional Chinese medicine in the treatment of early DKD pa tients was significantly better than that of the control group:[OR=3.69,95%CI(3.00,4.54),Z=12.36(P<0.00001)](7)Safety analysis,11 The number of cases of adverse reactions mentioned in the literature was[Chi~2=13.78,I~2=27%,OR=0.75,95%CI(0.51,1.11),P=0.15].2 Analysis results of medication ruleA total of 40 literatures were included for this study,including 38 Chinese herbal prescriptions,involving 109 Chinese herbs.Frequency analysis of traditional Chinese medicine:the top 5 in the order of frequency of use are astragalus,tuckahoe,salvia,codonopsis,and yam.Analysis of four qi and five flavors:the flat drugs were used t he most with a frequency of 120 times;the sweet drugs were used the most with a frequency of 248 times.Analysis of drug meridians:The meridians of the drugs from high to low frequency were spleen meridian,liver meridian,lung meridian and kidney meridian.Analysis of drug efficacy:the top 5 in the order of frequency of use are tonic medicine,blood circulation promoting and stasis removing medicine,diuresis and dampness medicine,heat-clearing medicine,and astringent medicine.Analysis of association rules of traditional Chinese medicines:The top 3 drug pairs used are"Astragalus-Poria","Astragalus-Salvia","Astragalus-Yam",and the core drugs are Astragalus,Salvia,and Poria.Cluster analysis:Three core groups were obtained to improve the inflam matory response in patients with early DKD.Conclusion:1.Comprehensive treatment of traditional Chinese medicine can effectively improve the inflammatory response in patients with early DKD;2.The comprehensive treatment of traditional Chinese medicine can effectively improve the renal function of patients with early DKD,thereby delaying the progress of the course of DKD;3.Traditional Chinese medicine comprehensive treatment can improve the total effective rate of early DKD patients and improve the symptoms of early DKD patients by improving renal function,lowering blood sugar,and adjusting blood lipids;4.It is relatively safe to comprehensively treat early DKD patients with traditional Chinese medicine;5.The most common drugs used by traditional Chinese medicine to improve the inflammatory response of early DKD are flat and sweet,and the main channels are the spleen,liver,lung and kidney channels.The core drugs for improving the inflammatory response of early DKD are huangqi,danshen,and fuling.