金匮肾气丸(汤)治疗糖尿病肾病的系统评价与Meta分析OA

Objective To systematically evaluate the clinical efficacy and safety of Jinkui Shenqi Pills(Decoction)in the treatment of diabetic nephropathy.Methods Seven databases were systematically searched,including CNKI,WANGFANG,VIP,CBM,PubMed,Embase and Cochrane Library,and the search time was limited to the period from inception till March 2023.The Cochrane Risk Assessment Tool(ROB 1.0)was used to evaluate the quality of the included literature,and Meta-analysis was performed by applying Review Manager 5.4 software.Results Twenty-two randomized controlled trials(RCTs)with a total sample size of 1 686 cases were eventually included.Meta-analysis results showed that the efficacy of Jinkui Shenqi Pills(Decoction)combined with conventional treatment of diabetic nephropathy was better than that of conventional treatment regimen alone,in which the total effective rate[RR=1.26,95%CI(1.20,1.32),P＜0.000 01],24-hour urine protein quantification(24hUP)[SMD=-4.40,95%CI(-5.52,-3.36),P＜0.000 01],urinary albumin excretion rate(UAER)[SMD=-3.80,95%CI=(-5.50,-2.10),P＜0.000 1],serum creatinine(Scr)[MD=-20.80,95%CI(-25.74,-15.86),P＜0.000 01],and blood urea nitrogen(BUN)[MD=-1.30,95%CI(-1.88,-0.72),P＜0.000 01]were better than the control group,and the differences were statistically significant;through subgroup analysis,the effect of Jinkui Shenqi Decoction was better than that of pill in reducing BUN;only 7 studies reported adverse effects,and this study can not yet draw conclusions about the safety Jinkui Shenqi Pills(Decoction)because of insufficient evidence.Conclusion Jinkui Shenqi Pills(Decoction)combined with conventional treatment can improve the overall clinical efficiency of diabetic nephropathy,reduce 24hUP,UAER,Scr and BUN,and is significantly more effective than conventional treatment of Western medicine alone.