Shenshuaining For Treatment Of Chronic Renal Failure:a Systematic Review

ObjectivesTo assess the efficacy and safety of Shenshuaining for treatment of chronic renal failure (CRF)MethodsWe searched CBM, CNKI, VIP, WANFANG, PubMed, EMBASE and Cochrane Library database for randomized controlled trials (RCTs) of Shenshuaining for treatment of chronic renal failure. Trial screening, quality assessment of included trials, and data extract were conducted by two reviewers independ-ently. Meta-analysis was conducted by using the Cochrane Collaborations software Revman5.0.Result13RCTs in Chinese language involving907patients met the criteria. Meta-analysis showed:①Shenshuaining capsule was more effective than routine treatment on clinical efficacy [RR=1.74,95%CI(1.45,2.08), P<0.00001], blood urea nitrogen (BUN)[WMD=-4.99,95%CI (-7.65,-2.34), P=0.0002] and serum creatinine (Scr)[WMD=-88.48,95%CI (-112.43,-64.53), P<0.00001]; Compared with routine treatment, Shenshuaining had similar effects on the improvement of Hb[WMD=0.13,95%CI (-5.33,5.58), P=0.96].②Compared with Coated Aldehyde Oxystarch (CAO), Shenshuaining was more effective than CAO on clinical efficacy[RR=1.70,95%CI(1.42,2.03), P<0.00001]、BUN[WMD=-3.78,95%CI(-6.79,-0.77), P=0.01] and Scr[WMD=-63.62,95%CI (-101.07,-26.18), P=0.0009]. However, Shenshuaining was not superior to CAO in improving Hb[WMD=5.91,95%CI(-2.54,14.37), P=0.17] and Ccr[WMD=19.79,95%CI (-3.77, 43.35), P=0.10];③Only6RCTs mentioned adverse events, but no severe adverse events were reported.ConclusionThe current evidence shows that Shenshuaining is effective and safe in treatment of CRF. Due to the limitation of included RCTs, the quality of outcomes are of low or extremely low level based on GRADE. More large-scale and high-quality RCTs are required to confirm the reliability of this study.