Efficacy and safety of Yishen Huashi granules combined with conventional therapy in the treatment of diabetic kidney disease: A systematic review and meta-analysis

• Published in: Heliyon 2024-10, Vol.10 (20), p.e39213, Article e39213
• Main Authors: Dai, Bo, Chen, Yanxu, Song, Chaoqun, Liu, Shilin, Chen, Jinying, Zhu, Zexin, Xu, Jian, Liu, Zhenru, Lin, Minghao, Yang, Huhu, Xu, Shengxian, Bao, Pengjie, Nan, Zheng
• Format: Article
• Language: English
• Subjects: albumins; blood; China; computer software; confidence interval; death; diabetes; Diabetic kidney disease; excretion; glucose; lipid metabolism; medicine; Meta-analysis; oxidative stress; protein content; Randomized controlled trials; relative risk; renal function; Review; spleen; statistical models; System review; systematic review; therapeutics; Traditional Chinese medicine; urea nitrogen; uremia; urine; Yishen Huashi granules
• ISSN: 2405-8440; 2405-8440
• DOI: 10.1016/j.heliyon.2024.e39213

Diabetic kidney disease(DKD) is a complication of diabetes. If not treated in time, it will lead to severe glomerular damage, causing irreversible damage, and ultimately may lead to uremia and even death. Yishen Huashi Granule (YSHS) is a Chinese patent medicine for treating DKD by invigorating the spleen and removing dampness, which has shown a good curative effect. This study systematically evaluated the clinical efficacy and blood biochemical improvement of YSHS combined with conventional therapy (CT) in treating DKD. By August 2024, four English databases (PubMed, Web of Science, the Cochrane Library, and Embase) and four Chinese databases (China National Knowledge Infrastructure (CNKI), Wanfang Database (WF), China Biological Medicine Database (CBM), and China Science and Technology Journal Database (VIP)) were searched to screen literature, extract information, and evaluate quality according to inclusion and exclusion criteria. The language of these literature is limited to Chinese and English, but not limited to published sources. Meta-analysis and bias analysis were performed using Steata 16 software and Review Manager 5.3 software. The bias risk tool in the Cochrane Handbook was used to assess the quality of the literature. At 95 % confidence interval (CI), relative risk (RR) and Cohen's d were used for the categorical and continuous variables, respectively. To evaluate heterogeneity, the Q test and I2 statistics were employed within a random-effects model framework. A total of 28 randomized controlled trials (RCTs) comprising 2416 patients were included in this study. There were 1200 patients in the control group and 1216 in the treatment group. Compared with CT, combined YSHS therapy is more effective at improving clinical efficiency rate [RR(95 % confidence interval (CI)) = 1.26(1.21, 1.32), I2 = 15.83 %], renal function (urinary albumin excretion rate [SMD(95%CI) = -1.72(-2.27, −1.17), I2 = 95.5 %], 24-h quantitative urine protein level [SMD(95%CI) = -1.50(-2.51, −0.50), I2 = 95.52 %], blood urea nitrogen [SMD(95%CI) = -1.13(-1.46, −0.81), I2 = 89.81 %], SCr [SMD(95%CI) = -2.34(-3.36, −1.32), I2 = 97.90 %], eGFR [SMD(95%CI) = 0.50(0.18,0.82), I2 = 51.51 %]), glucose metabolism levels (FBG [SMD(95%CI) = -0.50(-0.87, −0.14), I2 = 89.67 %], 2hPG [SMD(95%CI) = -0.83(-1.39, −0.26), I2 = 87.11 %], HbA1c [SMD(95%CI) = -0.79(-1.74, −0.15), I2 = 94.6 %]), lipid metabolism levels (TC [SMD(95%CI) = -1.53(-2.32, −0.75), I2 = 95.49 %], TG [SMD(95%CI) = -0.