Clinical efficacy and safety of Chinese herbal medicine for the treatment of patients with early diabetic nephropathy

Yang, Xiaomei; Hu, Chenling; Wang, Shengju; Qiu, Chen

doi:10.1097/md.0000000000020678

Cited by 14 publications

(10 citation statements)

References 23 publications

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“…CER was assessed based on the degree of improvement of TCM clinical symptoms before and after treatment. This evaluation criterion was widely used to evaluate the efficacy of TCM (55)(56)(57). Further, the node splitting method showed that the direct and indirect evidence supporting treatment efficacy was consistent.…”

Section: Discussionmentioning

confidence: 99%

Comparative Efficacy of Acupuncture-Related Techniques for Urinary Retention After a Spinal Cord Injury: A Bayesian Network Meta-Analysis

Qiu

et al. 2022

Front. Neurol.

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BackgroundUrinary retention is one of the most frequent complications of spinal cord injuries (SCI) and negatively impacts patient satisfaction and quality of life. Acupuncture as an integral part of traditional Chinese medicine (TCM) has recently drawn widespread attention for its potential in the management of urinary retention. However, there are many different styles of acupuncture-related techniques, and the optimal choice of acupuncture for urinary retention after SCI is still unclear. Hence, this study uses a Bayesian network meta-analysis (NMA) to compare the efficacy of different types of acupuncture therapies using both direct and indirect evidence.MethodsRandomized controlled trials of acupuncture-related techniques for treating urinary retention after SCI were retrieved from the following electronic databases: Pubmed, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), the Chinese Biomedical Literature Service System (SinoMed), the Wan-Fang database, and the Chinese Scientific Journals Database (VIP). The retrieval time was from inception to November 2020. Clinical effective rate (CER) was the primary outcome indicator and residual urine volume (RUV) was the secondary outcome indicator. A Bayesian NMA was performed using the Markov chain Monte Carlo method in R software (version 3.6.1) interfacing with JAGS software (version 4.3.0). The node-splitting method was used to identify inconsistencies. In addition, a comparative adjusted funnel plot was used to assess publication bias.ResultsA total of 26 randomized controlled trials involving 1,652 patients were included. Bayesian NMA showed that electroacupuncture combined with moxibustion ranks first in both CER and RUV. In addition, in terms of cumulative probability, electro-acupuncture combined with moxibustion ranked first in CER. The results of the node splitting method revealed that direct and indirect evidence were consistent (P > 0.05). In addition, publication bias was detected.ConclusionA Bayesian NMA that combined direct and indirect comparisons showed that electro-acupuncture combined with moxibustion had a better effect on urinary retention due to SCI. However, it still needs a large sample size and high-quality randomized controlled trials to verify this finding.Systematic Review Registration:https://inplasy.com/, identifier: INPLASY2021110005.

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Section: Discussionmentioning

confidence: 99%

Comparative Efficacy of Acupuncture-Related Techniques for Urinary Retention After a Spinal Cord Injury: A Bayesian Network Meta-Analysis

Qiu

et al. 2022

Front. Neurol.

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“…Treatment of CRF by TCM has elicited positive results, however, and this approach has led to a diversi cation of treatment methods, broadening developmental prospects for therapy [17]. To name but a few of the effects, TCM has had impressive achievements in relieving symptoms of CRF, protecting residual renal function, delaying the progress of the disease, and postponing the time of dialysis and the requirement for kidney transplantation, thereby greatly improving the quality of life for patients with CRF [18].…”

Section: Fig 9 Discussionmentioning

confidence: 99%

Preliminary study of the mechanism underlying how Jianshen Granules ameliorate renal failure in 5/6 nephrectomy model rats

Zhang²,

Kong³

et al. 2020

Preprint

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Background: Chronic renal failure (CRF) is a worldwide public health concern, and at present, there are limited treatment options available. Jianshen Granules, a traditional Chinese herbal medicine, have been used clinically in the treatment of renal diseases for a large number of years in the Air Force Medical Center of the Chinese People's Liberation Army (PLA), and have shown great efficacy. In the present study, both the effectiveness and the mechanism of action of Jianshen Granules to treat CRF were investigated. Methods: A rat model of CRF was established by 5/6 nephrectomy. Rats were administered with distilled water, Uremic Clearance Granules (UCGs), or Jianshen Granules. During the administration period, the physiological state of the rats was observed, and the biochemical parameters of interest were measured. The pathology of the kidney tissues were assessed using hematoxylin and eosin (H.E.), and Masson’s staining. In addition, the expression level of transforming growth factor‑β1 (TGF‑β1) was detected. Human kidney cells (HKC cells) were used to investigate the effects of Jianshen Granules on apoptosis induced by hydrogen peroxide (H2O2), whereas cell viability was assessed by Cell Counting Kit‑8 (CCK‑8) assay. The level of apoptosis, the mitochondrial membrane potential (MMP), and reactive oxygen species (ROS) and Ca2 + levels were measured using a flow cytometry. Results: The results revealed that Jianshen Granules could reduce the levels of serum creatinine, blood urea nitrogen, alanine aminotransferase and aspartate aminotransferase, and the volume of urine in CRF rats. Renal histopathological examinations revealed that Jianshen Granules had an ameliorative effect on renal injury. In addition, Jianshen Granules led to a marked decrease in TGF‑β1 levels in CRF rats. Following treatment with Jianshen Granules, cell viability and the level of the MMP increased, whereas the levels of ROS and Ca2+ were reduced significantly. The increased level of TGF‑β1 was detected in the H2O2‑treated group, although this increase was attenuated by treatment with Jianshen Granules. Conclusion: Taken together, the results of the present study have shown that Jianshen Granules are able to ameliorate renal failure in CRF rats, and to inhibit apoptosis of HKC cells induced by H2O2 via downregulation of TGF‑β1.

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“…The on-going RCT of Tangshen Formula aims to investigate its effectiveness and safety on treating type 2 DKD patients with macroalbuminuria ( Yan et al, 2016 ). The meta-analysis of RCTs shows the satisfied efficacy of combined Tripterygium wilfordii Hook, tripterygium glycosides, Ophiocordyceps sinensis, or Jinshuibao with conventional ACEI or ARB treatment against DKD ( Luo et al, 2015 ; Lu et al, 2018 ; Zhang et al, 2019b ; Ren et al, 2019 ; Wu et al, 2020 ; Yang et al, 2020 ).…”

Section: Clinical Application Of Chinese Herbal Medicine In Diabetic ...mentioning

confidence: 99%

Therapeutic mechanism and clinical application of Chinese herbal medicine against diabetic kidney disease

Chen

Wu²,

2022

Front. Pharmacol.

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Diabetic kidney disease (DKD) is the major complications of type 1 and 2 diabetes, and is the predominant cause of chronic kidney disease and end-stage renal disease. The treatment of DKD normally consists of controlling blood glucose and improving kidney function. The blockade of renin-angiotensin-aldosterone system and the inhibition of sodium glucose cotransporter 2 (SGLT2) have become the first-line therapy of DKD, but such treatments have been difficult to effectively block continuous kidney function decline, eventually resulting in kidney failure and cardiovascular comorbidities. The complex mechanism of DKD highlights the importance of multiple therapeutic targets in treatment. Chinese herbal medicine (active compound, extract and formula) synergistically improves metabolism regulation, suppresses oxidative stress and inflammation, inhibits mitochondrial dysfunction, and regulates gut microbiota and related metabolism via modulating GLP-receptor, SGLT2, Sirt1/AMPK, AGE/RAGE, NF-κB, Nrf2, NLRP3, PGC-1α, and PINK1/Parkin pathways. Clinical trials prove the reliable evidences for Chinese herbal medicine against DKD, but more efforts are still needed to ensure the efficacy and safety of Chinese herbal medicine. Additionally, the ideal combined therapy of Chinese herbal medicine and conventional medicine normally yields more favorable benefits on DKD treatment, laying the foundation for novel strategies to treat DKD.

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Clinical efficacy and safety of Chinese herbal medicine for the treatment of patients with early diabetic nephropathy

Abstract: Supplemental Digital Content is available in the text

Cited by 14 publications

References 23 publications

Comparative Efficacy of Acupuncture-Related Techniques for Urinary Retention After a Spinal Cord Injury: A Bayesian Network Meta-Analysis

Comparative Efficacy of Acupuncture-Related Techniques for Urinary Retention After a Spinal Cord Injury: A Bayesian Network Meta-Analysis

Preliminary study of the mechanism underlying how Jianshen Granules ameliorate renal failure in 5/6 nephrectomy model rats

Therapeutic mechanism and clinical application of Chinese herbal medicine against diabetic kidney disease

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