Systematic Evaluation Of The Clinical Efficacy Of Shenqi Dihuang Decoction In The Treatment Of Diabetic Nephropathy

1 Research purposeAccording to the results of systematic review,we give a comprehensive analysis about clinical efficacy and safety of Shenqi Dihuang Decoction in the treatment of diabetic nephropathy.2 Research MethodsFirst,Chinese and English databases are searched by computer,including 4 Chinese databases,CNKI,Wanfang Database,China Biomedical Literature Database(CBM),VIP database,and 3 English databases,The Cochrance Library,Embase database,Pubmed literature database.Then,collect Shenqi Dihuang Decoction for treatment of diabetic nephropathy in randomized controlled trials.Then,according to the corresponding criteria for screening,the literature was selected,and the Cochrance Collaboration Network Bias Risk Assessment Tool was used to assess the risk bias of the literature included in the systematic review and extract the corresponding data.The data are classified,and Revman 5.3 software recommended by Cochrance Collaboration Network is used to perform qualitative descriptive analysis or quantitative meta-analysis in a corresponding manner.Finally,the results of the system evaluation are explained and discussed.3 Research resultsAfter related searches,a total of 261 articles were retrieved,and finally 18 articles were included in the systematic review with a total of 1262 patients.The control types included in the study were divided into three categories:Shenqi Dihuang Decoction + hypoglycemic agents vs hypoglycemic agents(2 articles),Shenqi Dihuang Decoction and VS angiotensin-type drugs(3 articles),Shenqi Dihuang Decoction + Angiotensin Class VS angiotensin drugs(13 articles).In terms of reducing urinary albumin excretion,10 studies reported this outcome,and 1 study showed no significant difference in the efficacy of Shenqi Dihuang Tang combined with hypoglycemic agents and the use of hypoglycemic agents alone.One study showed that Shenqi Dihuang Decoction was superior to simple angiotensin-type drugs.The three-month study of 4 treatments reported that Shenqi Dihuang Decoction combined with angiotensin-type drugs was superior to single-use angiotensin-type drugs.A comparison of 4 items of the 8 weeks treatment of Shenqi Dihuang Decoction combined with angiotensin-type drugs used in the meta-analysis showed that Shenqi Dihuang Decoction combined with angiotensin-type drugs was superior to single-use angiotensin Drugs.In terms of reducing fasting blood glucose,13 studies reported this outcome measure.Two meta-analyses of Shenqi Dihuang Decoction combined with hypoglycemic agents and simple hypoglycemic agents showed that the efficacy of Shenqi Dihuang Decoction combined with hypoglycemic agents was not significantly different from the use of hypoglycemic agents alone.Two meta-analyses comparing Shenqi Dihuang Decoction and Angiotensin II group showed that Shenqi Dihuang Decoction was superior to simple angiotensin-type drugs.A comparison of 9 items of Shenqi Dihuang Decoction combined with angiotensin-type drugs and angiotensin-only drugs showed that 4 studies showed that the effect of Shenqi Dihuang Decoction combined with angiotensin-type drugs was not significantly different from the use of angiotensin-type drugs alone.Five studies showed that Shenqi Dihuang Decoction combined with angiotensin drugs was superior to single angiotensin drugs alone.In terms of reducing glycosylated hemoglobin,six studies reported this outcome,which was compared between Shenqi Dihuang Decoction combined with angiotensin drugs and angiotensin-only drugs.A 3-month study showed that Shenqi Dihuang Decoction combined with angiotensin-type drugs is superior to single-use angiotensin-type drugs.In a 5-week study of 8 weeks,after removing one possible source of heterogeneity,a meta-analysis of the remaining 4 studies showed that Shenqi Dihuang Decoction combined with angiotensin-type drugs was superior to angiotensin alone.In terms of lowering cholesterol,eight studies reported this outcome.Two studies showed that Shenqi Dihuang Decoction is superior to simple angiotensin-type drugs.Three interventions that were taken into the meta-analysis for 3 months showed that Shenqi Dihuang Decoction combined with angiotensin-type drugs was superior to single-use vasopressor therapy.Vegetarian drugs.After 3 weeks of treatment for 8 weeks,meta-analysis of the remaining 2 items after removing 1 possible source of heterogeneity showed that Shenqi Dihuang Decoction combined with angiotensin-type drugs was superior to angiotensin alone.In the reduction of triglycerides,eight studies reported this outcome.Two meta-analyses comparing Shenqi Dihuang Decoction and Angiotensin II group showed that the effect of Shenqi Dihuang Decoction was not significantly different from the use of angiotensin-type drugs alone.A comparative study of 6 items of Shenqi Dihuang Decoction combined with angiotensin-type drugs and angiotensin-only drugs,after removing one possible source of heterogeneity,a meta-analysis of the remaining five studies showed that Shenqi Dihuang Decoction Combination of angiotensin drugs is superior to single angiotensin drugs alone.In the reduction of serum creatinine,nine studies reported this outcome.One study showed that Shenqi Dihuang Decoction combined with hypoglycemic agents was superior to the use of hypoglycemic agents alone.One study showed that Shenqi Dihuang Decoction was superior to simple angiotensin-type drugs.A comparative study of 7 items of Shenqi Dihuang Decoction combined with angiotensin-type drugs and angiotensin-only drugs,after removing one possible source of heterogeneity,a meta-analysis of the remaining 6 studies showed that Shenqi Dihuang Decoction Combination of angiotensin drugs is superior to single angiotensin drugs alone.In the reduction of urea nitrogen,nine studies reported this outcome.One study showed that Shenqi Dihuang Decoction combined with hypoglycemic agents was superior to the use of hypoglycemic agents alone.One study showed that there was no significant difference between the efficacy of Shenqi Dihuang Decoction and the use of angiotensin drugs alone.A comparative study of 7 items of Shenqi Dihuang Decoction combined with angiotensin-type drugs and angiotensin-only drugs was used to remove 1 possible After the source of heterogeneity,a meta-analysis of the remaining 6 studies showed that Shenqi Dihuang Decoction combined with angiotensin-like drugs was superior to angiotensin alone.In terms of efficiency,12 studies reported this outcome measure.Two studies showed that the efficacy of Shenqi Dihuang Decoction combined with hypoglycemic agents was not significantly different from that of the use of hypoglycemic agents alone.Three studies showed that there was no significant difference between the efficacy of Shenqi Dihuang Decoction and the use of angiotensin drugs alone.Four studies showed that Shenqi Dihuang Decoction combined with angiotensin drugs was superior to single angiotensin drugs alone.Three studies have shown that Shenqi Dihuang Decoction combined with angiotensin-type drugs is superior to single-use angiotensin-type drugs.In terms of safety,13 studies did not mention the occurrence of adverse reactions,and 3 studies clearly stated that no obvious adverse reactions were seen.One study mentioned one case of cough in the control group.One study mentioned 3 cases of dizziness in the observation group,1 case of dry cough in the control group,1 case of headache,and 2 cases of dizziness.Because adverse reactions occurred in both the control group and the observation group,the efficacy of Shenqi Dihuang Decoction in reducing the occurrence of adverse reactions could not be concluded.4 Research conclusionsThrough the analysis of the results,we can find that Shenqi Dihuang Decoction can reduce 24-hour urinary protein,reduce urinary albumin excretion,lower cholesterol,lower triglycerides,lower glycosylated hemoglobin,lower blood creatinine,and lower urea nitrogen.There is great potential,but due to the limitations of this system evaluation,all of them are still unable to reach a definitive conclusion.It is still necessary to continue to carry out well-designed multi-center,large-scale randomized double-blind controlled trials.At the same time,the quality of the literature on randomized controlled trials of Shenqi Dihuang Decoction for the treatment of diabetic nephropathy remains to be further improved.The literatureshould be further strengthened in terms of reports of adverse reactions,timely records of follow-up visits,calculation of sample size,implementation of blinded methods,etc.