| ObjectiveWe conducted a meta-analysis to assess the effect of bailing capsual combing with angiotensin receptor blocker in the treatment of diabetic kidney disease.MethodsThe papers on bailing capsual combing with angiotensin receptor blocker in the treatment of Diabetic kidney Disease,published in databases of VIP,CNKI,Sino Med,PubMed,WAN FANG DATA,Web of Science,EMBASE from January 2012 to January 2018.We set "bailing capsule","diabetic kidney disease" and "traditional Chinese Medicine Therapy" as keywords.Using the experimental data for Meta-analysis.Firstly,two qualified evaluators who have passed the training will independently read and evaluate the quality of the literature.When the literature information is not clear,try to get in touch with the original author.After cross checking the results,if the two evaluators had different opinions on a particular study,the third evaluator discussed them together and decided whether to include this study.According to the Jada rating scale review methods,two reviewers independently screened the literature,exclusion and inclusion criteria,extracted data,assessed quality from the points of stochastic method,application of blind method,sample content,therapy,statistical method,follow-up and so on.were searched and meta-analysis was performed on the data by stata12.1.Using the experimental data for meta-analysis.Serum creatinine,BUN,The total cholesterol,blood glucose,glycolated hemoglobin,urinary albumin excretion rates,24-h urinary protein,C-reactive protein,systolic blood pressure,diastolic blood pressure,tortal Cholesterol,triglycercide,Clinical efficiency were analyzed in people with diabetic kidney disease.ResultsThere is a total of 12 studies were retrieved,a total of 1124 patients,of which 561 were in Bai Ling capsule combined with ARB(experimental group)and 563 were used in ARB alone(control group).1.Comparison of scr levels before and after treatment:The study on the combined effects of SMD =-0.647,95% CI [-1.153,-0.141].The research group and the control group comparison test after the merger,the difference was statistically significant(Z=6.67,P<0.00001).The results indicated that the experimental group was significantly superior to the control group in reducing the scr level;2.Comparison of BUN levels before and after treatment:The study on the combined effects of WMD =-1.33,95% CI [-1.956,-0.141].The research group and the control group comparison test after the merger,the difference was statistically significant(Z=4.2,P=0),The results showed that the experimental group was significantly better than the control group in reducing BUN levels;3.Comparison of UAER levels before and after treatment:The combined effect of each study was WMD =-6.949,95% CI [-18.414,4.517].The research group and the control group comparison test after the merger,the results showed no significant difference in the reduction of UAER levels.4.The comparison of 24 h urinary protein quantification levels before and after treatment:The study on the combined effects of SMD =-2.855,95% CI [-4.279,-1.430].The research group and the control group comparison test after the merger,the difference was statistically significant(Z=3.93,P=0),The results indicated that the experimental group was significantly better than the control group in reducing the 24-hour urine protein quantification level;5.Comparison of fasting blood glucose levels before and after treatment:The study on the combined effects of WMD =-0.229,95% CI [-0.286,-0.172].The research group and the control group comparison test after the merger,the difference was statistically significant(Z=7.92,P=0),The results indicated that the experimental group was significantly superior to the control group in reducing fasting blood glucose levels;6.Comparison of glycated hemoglobin levels before and after treatment:The study on the combined effects of WMD = 0.011,95% CI [-0.216,0.238].The research group and the control group comparison test after the merger,the results showed that the experimental group and the control group had no significant difference in reducing the level of glycohemoglobin.7.Comparison of CRP levels before and after treatment:The study on the combined effects of WMD=-3.489,95% CI [-5.54,-1.435].The research group and the control group comparison test after the merger,the difference was statistically significant(Z=3.33,P=0),The results indicated that the experimental group was significantly better at reducing the CRP level than the control group;8.Comparison of SBP levels before and after treatment:The study on the combined effects of WMD =-5.228,95% CI [-14.032,3.576].After the studies were combined,the results showed that there was no significant difference between the experimental group and the control group in reducing the SBP level.9.Comparison of DBP levels before and after treatment:The combined effect of each study was WMD =-2.193,95% CI [-10.886,6.499].After the studies were combined,the results showed that there was no significant difference between the experimental group and the control group in reducing DBP levels.10.Comparison of TC levels before and after treatment:The study on the combined effects of WMD =-0.598,95% CI [-1.246,0.05].The combined results of the studies showed that there was no significant difference between the experimental group and the control group in reducing TC levels.11.Comparison of TG levels before and after treatment:The study on the combined effects of WMD =-1.136,95% CI [-1.746,-0.526].The research group and the control group comparison test after the merger,the difference was statistically significant(Z=3.65,P=0),The results indicated that the experimental group was significantly better than the control group in reducing TG levels;12.Comparison of Clinical Efficacy:The study on the combined effects of RR was 1.385,95% CI [1.095,1.752].The research group and the control group comparison test after the merger,the difference was statistically significant(Z=2.72,P=0.007),The results indicated that the clinical efficacy of the test group was significantly better than that of the control group;ConclusionBailing capsule combined with ARB has obvious advantages in protecting kidney function and delaying DKD progression.Compared with simple ARB for DKD,it has obvious advantages in efficiency,reducing Scr,BUN,CRP,fasting blood glucose level,24 hour albuminuria,and TG.But the UAER,glycosylated hemoglobin level,blood pressure control level and TC did not show good clinical effect.The relevant mechanism of action remains to be further explored by us.Bailing Capsule Combined with ARB has not reported severe adverse reactions such as liver and kidney function impairment and hypersensitivity reaction in clinical application.It is safe and worthy of clinical application.However,in view of the limitations of this study,the accuracy and reliability of the results are reduced to a certain extent.So more large sample,multi center,and high quality randomized controlled trials are still needed to verify. |
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