A Meta-analysis Of ACEI Or ARB Drugs Combined With Chinese Herbal Compound For Invigorating Deficiency And Dredging Collaterals In The Treatment Of Diabetic Nephropathy

Purpose: To evaluate the efficacy and safety of the combination of tonifying deficiency and dredging collaterals with traditional Chinese medicine(TCM)combined with ACEI or ARB drugs in the treatment of diabetic nephropathy.Material and method : Retrieved 2013-2018 January CBM,CNKI,VIP,Wanfang database,Cochrane library,Embase,Medline,Pubmed,supplemented by manual search of relevant journals,collected randomized and semi randomized controlled trials about tonifying deficiency and dredging collaterals with traditional Chinese medicine combined with ACEI or ARB drugs in the treatment of DKD.After screening,extracting,and evaluating the methodological quality independently,two researchers used Revman 5.3software for Meta analysis.Results:1.A total of 36 Chinese literatures were included in 2149 diabetic nephropathy patients.Meta analysis showed that the combination of tonifying deficiency and dredging collaterals with ACEI or ARB drugs was effective in the treatment of clinical DKD patients(OR=3.65,95%CI[2.99,4.45]).The clinical effective rate of the two groups was statistically significant(P<0.00001).2.Microalbuminuria(SMD=-1.63,95%CI[-2.43,-0.83],the excretion rate of microalbuminuria in 24 h urinethe(SMD=-1.61,95%CI[-2.14,-1.09],24 h quantitative urinary protein(SMD=-0.85,95%CI[-1.14,-0.55]),serum creatinine(SMD=-0.48 95%CI,[-0.71,-0.25])and urea nitrogen(SMD=-0.49,95%CI[-0.66,-0.32])were better than the single ACEI or ARB drug group.Conclusion : Compared with single ACEI or ARB drugs,tonifying deficiency and dredging collaterals with ACEI or ARB drugs have remarkable curative effectclinical curative effect,can significantly reduce the mAlb,UAER,24 h UTP,Scr,BUN.