Meta-analysis Of Artificial Aweto Preparation In Treating Chronic Renal Failure

Objective:The systematical evaluation of curative effect and safety of artificial aweto preparation in the treatment of chronic renal failure,which provide clinical references of the use of evidencebased support.Methods:According to the guiding principles of evidence-based medicine,the studies on artificial aweto preparation in treatment of chronic renal failure in the last 10 years were collected through manual retrieval and computer retrieval on Cochrane collaboration,PubMed,EMbase,CNKI,CBM and other databases.According to the inclusion and exclusion criterion,qualified researches were strictly screened.Data extraction,quality assessment of the selected research are carried out by two researchers.The information registration form of "artificial aweto preparation in the treatment of chronic renal failure" was made by the software Excel 2013.Quality assessment of studies included improved Jadad scoring and bias risk assessment.Statistical analysis included Meta-analysis and descriptive analysis.The software Rev Man5.3 was used to conduct Meta-analysis of effective data as well as the forest map was made and interpreted.The funnel plot recommended by Cochrane Handbook was used for detection of publication bias.Objective to systematically evaluate the efficacy and safety of artificial aweto preparation in treating chronic renal failure.Results:There were 25 researches and 2217 patients met the inclusion criterion.There were 1114 cases in the combined group and 1103 cases in the control group.1338 male patients and 879 female patients were included.The test time ranged from 2 to 24 weeks.Interventions in the combined group included artificial aweto preparation.(1)Meta-analysis of the artificial aweto preparation on renal function in patients with chronic renal failure indicated that artificial aweto preparation combined routine treatment gave better results in increasing estimated glomerular filtration rate(eGFR)[MD5.72,95%CI(3.26,8.18)],creatinine clearance rate(Ccr)[MD5.53,95%CI(4.42,6.64)],and also lowering serum creatinine(Scr)[MD-52.37,95%CI(-63.45,-41.29)],uric acid(UA)[MD-93.99,95%CI(-118.21,-69.77)].The combination of Jinshuibao capsule and conventional therapy was superior to routine treatment in reducing blood urea nitrogen(BUN)[MD-2.87,95%CI(-3.70,-2.03)],and Bailing capsule combined with conventional therapy was not different from routine treatment in reducing BUN[MD-0.82,95%CI(-1.73,0.08)],but the result is not stable.(2)Meta-analysis of the effect of artificial aweto preparation on serum albumin in patients with chronic renal failure indicated that artificial aweto preparation combined routine treatment gave better results in increasing albumin [MD1.90,95%CI(1.13,2.67)].(3)Meta-analysis of the influence of artificial aweto preparation on anemia in patients with chronic renal failure indicated that there is no statistically significant for increasing the hemoglobin(Hb)[MD1.69,95%CI(-0.82,4.21)] and red blood cell(RBC)(P>0.05)compared with conventional therapy alone.(4)Meta-analysis of the effect of artificial aweto preparation on urine indexes in patients with chronic renal failure indicated that the interventions in combined group gave better results in lowering 24 h urinary protein(24hpro)[MD-0.44,95%CI(-0.49,-0.39)] and the quantity of urine red blood cell(P <0.05).(5)Meta-analysis of the effect of artificial aweto preparation on blood lipids in patients with chronic renal failure showed that combination group was better than the control group in reducing total cholesterol[MD-0.60,95%CI(-0.83,-0.38)],triglyceride(P <0.01)and lowdensity lipoprotein cholesterol(P <0.05).(6)Meta-analysis of the influence of artificial aweto preparation on inflammation related fact in patients with chronic renal failure showed that combination group was better than the control group in reducing C-reactive protein(CRP)and high-sensitivity C-reactive protein(hs-CRP)[MD-2.98,95%CI(-3.72,-2.23);MD-1.67,95%CI(-2.38,-0.97)] and interleukin-6(IL-6)[MD-29.80,95%CI(-33.93,-25.67)].(7)There was no serious adverse reaction in the both two groups of patients.Conclusion:Artificial aweto preparation combined with conventional therapy improved the patient’s renal function,serum albumin and also decreased blood lipid and micro inflammation,but can not significantly improve the patient’s anemia,the effect of improving the BUN was not accurate.Due to low quality of included studies,pending further high-quality researches to study its efficacy and safety.