Systematic Review Of Shenyankangfu Tablet For Diabetic Nephropathy (DN) And Chronic Glomerulonephritis(CGN)

Objective:To systematically evaluate the curative effect and safety of Shenyankangfu Tablet in treatment of Diabetes Nephropathy(DN) and Chronic Glomerulonephritis(CGN). And to provide scientific basis for the direction of treatment of integrated traditional Chinese and Western Medicine.Methods:Searching the pertinent literatures of randomized controlled trial of Shenyankangfu Tablet in the following databases:Cochrane Library, Medline, EMbase, CBM, CNKI, VIP and Wanfang databases (since each database built to 2014.10). To prevent the omission, about 16 Chinese core journals were searched by hand at the same time. Asessing trial qualities and extracted data from these Randomized Controlled Trails by the RevMan5.2.Results:This study systematically evaluates the application of Shenyankangfu Tablet in DN and CGN in two parts. (1) DN:There are 11 papers into the related research with a total of 814 participants (415 in trial group,399 in control group). Its methodological quality assessment shows that:there are 2 papers with score 3,7 papers with score 2,2 papers with score 1, so the overall quality is low. The careful analysis of the included studies finds that the control group adopts different intervening measure, so this study is divided into three subgroups for analysis respectively. ① Compare Shenyankangfu Tablet+conventional treatment group with the conventional treatment group:compared to the latter, Shenyankangfu Tablet has statistical significance in enhancing the clinical efficacy, and the curative effect is superior to control group [RD=0.26,95% CI (0.08,0.44)]; at the same time, it also improves the 24h urine protein quantitation [WMD=-0.59,95% CI (-0.71,-0.47)], excretion rate of urine microalbumin [WMD=-63.30,95% CI (-0.71,-0.47)] and serum creatinine [WMD=-62.21,95% CI (-66.95,-57.47)] obviously.② Compare Shenyankangfu Tablet+conventional treatment group with the western medicine+ conventional treatment group:nephritis tablet can improve the clinical effect significantly [RD=0.16,95% CI (0.06,0.25)], and its effect is also superior to western medicine in the aspect of proteinuria and renal function. ③ Compare Shenyankangfu Tablet+western medicine+conventional treatment group with the western medicine +conventional treatment group:Shenyankangfu Tablet plays no improving role in clinical curative effect, but its effect for 24h urine protein quantitation [WMD=-0.47, 95% CI (-1.11,0.18)], serum creatinine [WMD=-5.54,95% CI (-9.09,-2.00)], urea nitrogen [WMD=-0.50,95% CI (-0.97,-0.03)] is better than the latter. In addition, three subgroup Meta-analysis shows that Shenyankangfu Tablet does not influence the FBG, HBALC, TCHO and TG of the DN patients.2:CGN:there are 9 papers into the related research with a total of 927 participants (509 in trial group,418 in control group). Its methodological quality assessment shows that:there are 7 papers with score 3,2 papers with score 2, so the overall quality is low. The Meta analysis shows that Shenyankangfu Tablet can improve the clinical effect of CGN, which is statistically significant [OR=2.86,95% CI (1.95,4.18)]; it also has significant curative effect for proteinuria [WMD=-0.33,95% CI (-0.56,-0.10)]. But according to the analysis, Shenyankangfu Tablet does not improve the renal function (serum creatinine and urea nitrogen) and high blood pressure (systolic and diastolic blood pressure) of the CGN patients. In the aspect of security, the study has reported about the adverse effect of the rash, abdominal distention, diarrhea, and cough. Among them, there are 9 cases in DN group,6 cases in CGN group; the number in treatment group is more than that in control group; but because of the lack of detailed data, the combined analysis cannot be conducted, therefore, only the descriptive comment is made.Conclusion:This study shows that joint Shenyankangfu Tablet can improve the clinical effect of DN, help reduce the proteinuria symptoms of patients, improve the renal function; in respect of CGN, the joint Shenyankangfu Tablet can improve the patients’ proteinuria symptoms significantly. However, due to the limitations of the quality and quantity of literatures in this research, the evidence of curative effect of the joint Shenyankangfu Tablet for DN and CGN is still very limited; therefore, the results of this study should be treated carefully.