| Objective: To evaluate the efficacy and safety of Astragalus membranaceus(preparation of Astragalus membranaceus and compound prescription containing astragalus membranaceus)in the treatment of adult idiopathic membranous nephropathy;Methods: Manual retrieval of relevant journals and electronic retrieval of multiple databases were used for literature preliminary examination.Electronic retrieval of English databases included PUBMED,EMBASE and Cochrane full-text databases;Chinese databases included Vip,Wanfang,CNKI and Sino Med.The retrieval years were set up until August 2018.The English database is based on "membranous nephropathy","membranous glomerulonephritis","traditional Chinese medicine","milkvetch root","randomized controlled trials","clinical trials",and the Chinese database is based on "membranous nephropathy,idiopathic membranous nephropathy,traditional Chinese medicine,Chinese medicine,Qi supplementation,astragalus,clinical research,clinical observation,randomized controlled trials".” For search terms.Manual search of relevant journals(2008.01-2018.08)and tracking of relevant references to ensure the comprehensiveness of the included literature.End Note,a document management software,will be used to build a database of selected documents,exclude duplicate documents by software,and then exclude non-conforming and duplicate published documents by reading headlines and abstracts.Finally,the full text will be obtained,and detailed information including methodological features will be obtained by reading the full text.If necessary,contact the author of the article to understand the relevant situation.Two researchers extracted data strictly and independently according to the table,carefully screened,and when confronted with divergent opinions,the two sides discussed the solution or judged whether to include the literature by the third.Cochrane Risk Bias Assessment Tool was used to evaluate the quality of selected qualified documents,and the included research application Review Manager 5.3 software was systematically evaluated.Results: A total of 13 articles were included in this study,including 877 IMN patients,422 in the experimental group and 455 in the control group.The results showed that the total remission rate of IMN treated with Astragalus membranaceus was significantly higher than that treated with western medicine alone [OR = 2.10,95% CI(1.47,3.01),Z = 4.08(P <0.0001)].The treatment group with Astragalus membranaceus was better than the control group in reducing urinary protein,the difference between the two groups was significant,[WMD=-0.87,95% CI(-1.67,-0.77),Z=18.03(P<0.00001)];the treatment group with Astragalus membranaceus was better than the control group in increasing serum albumin,the difference was significant,[OR=2.23,95% CI(1.13,3.33),Z=3.96(P<0.0001)];The effect of astragalus group on lowering blood cholesterol was better than the control group,and the difference was statistically significant.[WMD=-0.92,95% CI(-1.12,-0.72,95%CI(-1.12,-0.72),Z = 8.84(P < 0.00001)] [WMD=-0.92,95% CI(-1.12,-0.72,-0.72),Z =8.84(P < 0.00001)] [OR=-0.48,95% CI(-0.78,-0.78,-0.17,-0.17,-0.17,Z = 3.03(P=0.002)] [OR=-0.23,95% CI(-0.23,95% CI(-5.95% CI(-5.50,95% CI(-5.50(-P = 0.The effect of reducing urea nitrogen in the Astragalus group was similar to that in the control group,with no significant difference [WMD = 0.13,95% CI(-0.38,0.11),Z =1.07(P = 0.29)];the incidence of adverse reactions in the Astragalus group was lower than that in the control group,with significant difference [OR = 0.25,95% CI(0.15,0.44),Z =4.97(P < 0.00001)].The results show that the distribution of scatter points in the inverted funnel plot is approximately symmetrical,and there may be a smaller publication bias.Comprehensive quality evaluation of 24-hour urinary protein quantification,the main outcome index of this meta-analysis,showed that the evidence of 24-hour urinary protein quantification was classified as low quality.Conclusion: Astragalus membranous nephropathy can effectively improve the clinical total effective rate,increase the plasma albumin level,reduce the 24-hour urinary protein level,reduce the serum total cholesterol and triglyceride levels,and reduce the incidence of adverse reactions,which is significantly better than that of the simple western medicine treatment group.Chinese medicine containing astragalus membranaceus may not reduce the serum creatinine and urea nitrogen levels,but there is no significant difference compared with the control group.Objective: To observe the acute toxicity test of Qidigushen tablet to study whether oral administration of this drug can produce acute toxicity to the body.Methods: The acute toxicity of Qidigushen tablets was investigated by single-dose intragastric administration with the maximum concentration(0.562g/ml)and the maximum volume(0.4m L/10 g body weight)and multiple maximum intraday administration tests in mice.Results: By observing the acute toxicity test of mice,the results showed that there were no abnormal changes in the mental status,diet and exercise status of mice.The mice were given orally once at the maximum concentration and volume,which could not cause death of mice.The single dose was 22.48 g/kg,three times within 24 hours,and the cumulative maximum dose was 202.32 g./ Kg,there was no obvious toxic reaction.Conclusion: Qidi Gushen Tablet is actually non-toxic and safe. |
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