| Purpose:The clinical efficacy of invigorating Qi and nourishing Yin and activating blood in the treatment of diabetic nephropathy was analyzed by meta-analysis,and the medication rules of TCM compound with the main treatment method of invigorating qi and nourishing Yin and activating blood were analyzed by the cloud platform of ancient and modern medical records,so as to provide evidence-based medical evidence for the further application of invigorating qi and nourishing Yin and activating blood in the treatment of diabetic nephropathy.Material and method:1.Strictly following the inclusion criteria and exclusion criteria,computer search CNKI,VIP,China Academic Journal Database(Wanfang),Pubmed and other electronic journal databases,supplemented by manual search,search the published Chinese literature and foreign literature from the establishment of the database to January 2023.Clinical randomized controlled trial of invigorating qi and nourishing Yin and activating blood circulation for diabetic nephropathy.Quality assessment tables provided by the Cochrane Collaboration network were used to evaluate the quality of all literatures included.Meanwhile,meta-analysis of dichotomous data or continuous data was performed for all literatures meeting the criteria by Revman 5.3 statistical software.and forest maps and funnel plots were made.2.All the literatures retrieved above were re-screened according to the Narrows standard,and then Excel was used to establish the drug use law database and input the ancient and modern medical records cloud platform.The data analysis module of the cloud platform was used to summarize the drug use law.Results:1.A total of 15 RCTS with 1182 patients meeting the criteria were included in this meta-analysis.Among them,there were 7 B-grade literatures and 8 C-grade literatures.2.The results showed that compared with the same conventional western medicine control group(P﹤0.05,the difference was statistically significant),Treatment group in reducing diabetic nephropathy patients urinary albumin excretion rate(UAER),blood creatinine(Scr),urea nitrogen(BUN),fasting blood glucose(FPG),two hours after meal blood glucose(2h-PG),glycosylated hemoglobin(Hb Alc)and other aspects,the efficacy is better than the control group;Compared with the control group,it can significantly improve the clinical effective rate and improve the clinical symptoms of traditional Chinese medicine.However,more abundant literature is needed to support the evidence on the reduction of triglyceride(TG)and total cholesterol(TC).3.Funnel plot is relatively symmetrical,good safety,and no serious adverse reactions.4.After screening,75 studies were in line with the analysis conditions of drug inclusion law,involving 95 TCM,with a total frequency of 888.The top 10 high-frequency TCM applied in the treatment of diabetic nephropathy by qi and Yin and blood circulation method were successively: Astragalus membranaceus,salvia miltiorrhiza,yam,Radix rehmanniae,dogwood,fulia coia,ligusticum Chuanxiusticum,Angelica sinensis,atractylosum and safflower.The commonly used traditional Chinese medicine mainly has calming and warming properties,and its medicinal flavors are mainly sweet,sweet and bitter,which are mostly attributed to liver,spleen,lung and kidney channels.High frequency drug pairs were: Radix Rehmanniae-Radix Astragalus,Poria cocos-Radix Astragalus,ligusticum Chuanxiong-Radix Astragalus,Angelica-Radix Astragalus,Radix atractyloides-Radix Astragalus.Conclusion:1.1.TCM Qi-nourishing and blood-activating method has a good effect on improving clinical symptoms and clinical effective rate of DKD patients,as well as reducing urinary albumin excretion rate,blood creatinine,blood urea nitrogen,fasting blood glucose,2 hours postprandial blood glucose,glycosylated hemoglobin and other aspects.It has fewer side effects and relatively high safety.However,there are still some deficiencies and limitations in this meta-analysis.Therefore,it is suggested to carry out more rigorously designed RCTS with large body mass samples in the later period to eliminate publication bias and enhance the credibility of the article,so as to provide further clinical guidance for the application of TCM qi nourishing Yin and blood activating method in the treatment of diabetic nephropathy.2.2.The top ten high frequency herbs applied in the treatment of diabetic nephropathy by qi nourishing Yin and blood activating method are: Radix Astragalus,Danshen,yam,Radix rehmanniae,cornus officinalis,poria,ligusticum ligusticum,Angelica sinensis,Rhizoma atractylosum and safflower.The commonly used traditional Chinese medicine mainly has calming and warming properties,and its medicinal flavors are mainly sweet,sweet and bitter,which are mostly attributed to liver,spleen,lung and kidney channels.High frequency drug pairs were: Radix Rehmanniae-Radix Astragalus,Poria cocos-Radix Astragalus,ligusticum Chuanxiong-Radix Astragalus,Angelica-Radix Astragalus,Radix atractyloides-Radix Astragalus. |
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