Systematic Review Of Compound Chinese Herbal Retention Enema Therapy For Chronic Renal Failure

Objectives:Using the EBM method to evaluate the efficiency and safety of compound Chinese herbal retention enema therapy for chronic renal failure.To review systematically whether there are enough existing evidences that compound Chinese herbal retention enema therapy for chronic renal failure is effective and safe.Methods:Cochrane Controlled Trials Register (CCTR),PubMed,Embase and Chinese Biological Medicine database(CBM),China National Knowledge Infrastructure (CNKI),WeiPu data (VIP) and WanFang data were widely referred.More than 10 Chinese core journals related to TCM during 2009 were also searched by hand.Two authors independently assessed trial qualities and extracted data from these Randomized Controlled Trails, then imported them into the Meta-analysis by Rev.Man 5.0.23 or did the descriptive analysis those who could not do the Meta-analysis.Results:49 studies (3906 patients) were identified. The results of Meta-analysis indicated:there are evidences to support that compound Chinese herbal retention enema therapy combining with Western-based treatment for chronic renal failure is better than Western-based treatment group and the group of Intestinal adsorbents (Coated Aldehyde Oxystarch or/and Medicinal Charcoal) oral treatment combining with Western-based treatment only on symptom physical sign and increasing the level of endogenous creatinine clearance rate and decreasing the level of serum creatinine, urea nitrogen, uric acid,but hemoglobin, lipids, calcium and phosphorus levels is not included,the 24h urine protein level decrease is also decreasing in some tests. However, the methododlogical quality is considered low in these stulevels of prevention.Conclusions:Based on the aforementioned results, conclusions could be drawn that compound Chinese herbal retention enema therapy for chronic renal failure can improve the clinical efficacy and renal function, and it is more effective than intestinal adsorbents (Coated Aldehyde Oxystarch or/and Medicinal Charcoal) oral treatment. However, the evidence is not enough strong because of the low qualities of trials, the small sample sizes in some researches and not long enough treatment and follow-up time. Therefore, these results should be interpreted with caution. The exact effect need to design a strict multi-center, large sample randomized controlled trials further confirmed.