| Objective:To evaluate the Clinical efficacy and safety of Chinese medicine on treating microinflammatory state in chronic renal failure(CRF)based on Meta-analysis,so as to provide evidence-based basis for clinical practice.To observe the clinical efficacy of Bushen Yiqi Decoction in improving microinflammatory state in chronic renal failure(CRF)(spleen and kidney Qi deficiency,dampness retention and stasis).Methods:1.Meta-analysis:we searched systematically the clinical research literature published before December 31,2021 on the treatment for chronic renal failure with microinflammatory status by Traditional Chinese medicine.The databases mainly include the CNKI,VIP,Wan Fang,Sinomed and Pubmed.Two reviewers screened the study,extracted data according to the inclusion and exclusion criteria,then the Cochrane risk bias assessment tool was used to evaluate the quality of the literature,we used Re Man5.3 software to perform statistical analysis on the clinical reported outcomes.2.Patients admitted to the the Department of Nephrology of the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine from January 2020 to December 2021were selected for retrospective analysis.and they are in accordance with chronic renal failure(CRF)with microinflammatory status,TCM syndrome differentiation belongs to the spleen and kidney Qi deficiency,dampness retention and stasis.Patients who met the case criteria of this study were divided into control group(36cases)and observation group(38 cases)according to different treatment regimens.The control group was only treated with Western basic treatment,while the observation group was treated with Western basic treatment combined with Bushen Yiqi Decoction for 8 weeks.The changes in the TCM syndrome score and laboratory indexes(hs-CRP,ALB,Scr,BUN,GFR)before treatment and at the 8th weeks of treatment were observed.SPSS 25.0 was used for statistical processing to analyze the efficacy and safety of Bushen Yiqi Decoction in treating the micro-inflammatory state of patients with CRF with(spleen and kidney Qi deficiency,dampness retention and stasis).Results:1.Meta-analysis:A total of 1428 articles were retrieved,and20 articles were eventually collected.The total number of subjects were 1742,including877 in the experimental group and 865 in the control group.(1)The differences between Traditional Chinese medicine combined with conventional basal therapy versus basal therapy alone in reducing inflammatory factors were statistically significant:hs-CRP were reported by17 studies in total,combined effect size:I~2=80%,P<0.00001,subgroup analysis was performed and the results were homogeneous across subgroups(I~2<25%),all statistically significant(P<0.0001);IL-6 were reported by 16studies in total,combined effect size shows that SMD=-0.72,95%CI=[-0.84,-0.60],P<0.00001;TNF-αwere reported by 14 studies in total,combined effect size shows that SMD=-1.19,95%CI=[-1.53,-0.85],Z=6.93(P<0.00001)).(2)The differences between Chinese medicine combined with conventional basal therapy and basal therapy alone were statistically significant in terms of improved renal function and Elevation of Hb,ALB:Scr(SMD=-0.80,95%CI[-1.14,-0.46],Z=4.63,P<0.00001);BUN(SMD=-1.26,95%CI[-1.87,-0.64],Z=4.02,p<0.0001);GFR(SMD=0.93,95%CI[0.74,1.12],Z=9.47,P<0.00001);Hb(SMD=0.76,95%CI[0.54,0.97],Z=6.90,P<0.00001);ALB(MD=3.46,95%CI[2.75,4.16],Z=9.55,P<0.00001).(3)Safety analysis:A total of 7 studies were reported,combined effect size shows that RR=1.05,95%CI=[0.55,2.01],P=0.88>0.05),difference not statistically significant.2.Retrospective syudy:(1)In terms of total disease efficacy:the overall effective rate of the observation group and control group is 81.58%and63.89%,the observation group was able to improve clinical efficacy;(2)In reducing the symptom score of TCM:The TCM evidence score decreased in both groups after treatment,The effective rate of the observation group in reducing TCM syndromes was 92.11%,higher than that of the control group(75.00%),and there was statistical difference between the two groups(P<0.05);(3)In terms of micro-inflammatory indicators:both groups were able to improve micro-inflammatory indicators.Compared with the control group,the observation group reduced hs-CRP and increased ALB levels more significantly(P<0.05);(4)In the improvement of renal function indicators:both groups were able to improve renal function,compared with the control group,the observation group can reduce Scr,BUN and increasing GFR levels more significantly(P<0.05).Conclusion:1.Meta-analysis:Traditional Chinese medicine combined with Western medicine can effectively improve the micro inflammatory state of CRF patients and lowering the levels of hs-CRP,IL-6 and TNF-αwith high security compared with the control group.2.Retrospective syudy:Bushen Yiqi Decoction can effectively improve the clinical symptoms,reduce hs-CRP levels,increase the content of ALB,improve micro-inflammatory state and protect kidney function of chronic renal failure(CRF)patients,which belongs to spleen and kidney Qi deficiency,dampness retention and stasis type. |
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