PDF(Pubmed)
Abstract：
UNASSIGNED: To determine the efficacy and safety of Astragalus combined with renin-angiotensin-aldosterone system (RAAS) blockers in treating stage III diabetic nephropathy (DN) by meta-analysis.
UNASSIGNED: PubMed, Embase, Cochrane Library, Wiley, and Web of Science databases were searched for articles published between August 2007 and August 2022. Clinical studies on Astragalus combined with RAAS blockers for the treatment of stage III DN were included. Meta-analysis was performed by RevMan 5.1 and Stata 14.3 software.
UNASSIGNED: A total of 32 papers were included in this meta-analysis, containing 2462 patients from randomized controlled trials, with 1244 receiving the combination treatment and 1218 solely receiving RAAS blockers. Astragalus combined with RAAS blockers yielded a significantly higher total effective rate (TER) (mean difference [MD] 3.63, 95% confidence interval [CI] 2.59-5.09) and significantly reduced urinary protein excretion rate (UPER), serum creatinine (Scr), blood urine nitrogen (BUN) and glycosylated hemoglobin (HbAlc) levels. In subgroup analysis, combining astragalus and angiotensin receptor blocker significantly lowered fasting plasma glucose (FPG) and 24 h urinary protein (24hUTP) levels, compared with the combined astragalus and angiotensin-converting enzyme inhibitor treatment. Meanwhile, the latter significantly decreased the urinary microprotein (β2-MG). Importantly, the sensitivity analysis confirmed the study\'s stability, and publication bias was not detected for UPER, BUN, HbAlc, FPG, or β2-MG. However, the TER, SCr, and 24hUTP results suggested possible publication bias.
UNASSIGNED: The astragalus-RAAS blocker combination treatment is safe and improves outcomes; however, rigorous randomized, large-scale, multi-center, double-blind trials are needed to evaluate its efficacy and safety in stage III DN.
Renin-angiotensin-aldosterone system (RAAS) inhibitors are commonly used to treat diabetic neuropathy (DN) and Astragalus membranaceus components are known to improve DN symptoms.We aimed to establish the efficacy and safety of using Astragalus combined with RAAS inhibitors.Astragalus combined with RAAS inhibitors enhances the total effective rate of diabetic neuropathy response to treatment and reduces urinary protein excretion rate, serum creatinine, blood urea nitrogen and HbAlc.Sensitivity analysis affirms study stability, while publication bias was detected for total effective rate, serum creatinine, and 24 h urinary protein levels.
UNASSIGNED: PubMed, Embase, Cochrane Library, Wiley, and Web of Science databases were searched for articles published between August 2007 and August 2022. Clinical studies on Astragalus combined with RAAS blockers for the treatment of stage III DN were included. Meta-analysis was performed by RevMan 5.1 and Stata 14.3 software.
UNASSIGNED: A total of 32 papers were included in this meta-analysis, containing 2462 patients from randomized controlled trials, with 1244 receiving the combination treatment and 1218 solely receiving RAAS blockers. Astragalus combined with RAAS blockers yielded a significantly higher total effective rate (TER) (mean difference [MD] 3.63, 95% confidence interval [CI] 2.59-5.09) and significantly reduced urinary protein excretion rate (UPER), serum creatinine (Scr), blood urine nitrogen (BUN) and glycosylated hemoglobin (HbAlc) levels. In subgroup analysis, combining astragalus and angiotensin receptor blocker significantly lowered fasting plasma glucose (FPG) and 24 h urinary protein (24hUTP) levels, compared with the combined astragalus and angiotensin-converting enzyme inhibitor treatment. Meanwhile, the latter significantly decreased the urinary microprotein (β2-MG). Importantly, the sensitivity analysis confirmed the study\'s stability, and publication bias was not detected for UPER, BUN, HbAlc, FPG, or β2-MG. However, the TER, SCr, and 24hUTP results suggested possible publication bias.
UNASSIGNED: The astragalus-RAAS blocker combination treatment is safe and improves outcomes; however, rigorous randomized, large-scale, multi-center, double-blind trials are needed to evaluate its efficacy and safety in stage III DN.
Renin-angiotensin-aldosterone system (RAAS) inhibitors are commonly used to treat diabetic neuropathy (DN) and Astragalus membranaceus components are known to improve DN symptoms.We aimed to establish the efficacy and safety of using Astragalus combined with RAAS inhibitors.Astragalus combined with RAAS inhibitors enhances the total effective rate of diabetic neuropathy response to treatment and reduces urinary protein excretion rate, serum creatinine, blood urea nitrogen and HbAlc.Sensitivity analysis affirms study stability, while publication bias was detected for total effective rate, serum creatinine, and 24 h urinary protein levels.
摘要：
■通过荟萃分析确定黄芪联合肾素-血管紧张素-醛固酮系统（RAAS）阻滞剂治疗III期糖尿病肾病（DN）的有效性和安全性。
■PubMed,Embase,科克伦图书馆,威利,和WebofScience数据库搜索2007年8月至2022年8月发表的文章。纳入黄芪联合RAAS受体阻滞剂治疗III期DN的临床研究。采用RevMan5.1和Stata14.3软件进行Meta分析。
■本次荟萃分析共包括32篇论文，包含来自随机对照试验的2462名患者，1244人接受联合治疗，1218人仅接受RAAS阻滞剂。黄芪联合RAAS阻滞剂的总有效率（TER）（平均差[MD]3.63，95％置信区间[CI]2.59-5.09）和尿蛋白排泄率（UPER）显着降低，血清肌酐(Scr),血尿氮（BUN）和糖化血红蛋白（HbAlc）水平。在亚组分析中，联合黄芪和血管紧张素受体阻滞剂显著降低空腹血糖（FPG）和24h尿蛋白（24hUTP）水平，与黄芪和血管紧张素转换酶抑制剂联合治疗比较。同时,后者显着降低了尿微量蛋白（β2-MG）。重要的是,敏感性分析证实了研究的稳定性，UPER未检测到发表偏倚，BUN,HbAlc,FPG,或β2-MG。然而,TER,SCr,24hUTP结果提示可能的发表偏倚。
■黄芪-RAAS阻滞剂联合治疗是安全的，可改善预后；然而，严格随机，大规模,多中心,需要双盲试验来评估其在III期DN中的疗效和安全性.
肾素-血管紧张素-醛固酮系统（RAAS）抑制剂通常用于治疗糖尿病性神经病（DN），黄芪成分已知可改善DN症状。我们旨在建立黄芪与RAAS抑制剂联合使用的有效性和安全性。黄芪联合RAAS抑制剂可提高糖尿病神经病变治疗的总有效率，降低尿蛋白排泄率，血清肌酐,血尿素氮和HbAlc.敏感性分析确认了研究的稳定性，而发表偏倚被检测为总有效率，血清肌酐,和24小时尿蛋白水平。
■PubMed,Embase,科克伦图书馆,威利,和WebofScience数据库搜索2007年8月至2022年8月发表的文章。纳入黄芪联合RAAS受体阻滞剂治疗III期DN的临床研究。采用RevMan5.1和Stata14.3软件进行Meta分析。
■本次荟萃分析共包括32篇论文，包含来自随机对照试验的2462名患者，1244人接受联合治疗，1218人仅接受RAAS阻滞剂。黄芪联合RAAS阻滞剂的总有效率（TER）（平均差[MD]3.63，95％置信区间[CI]2.59-5.09）和尿蛋白排泄率（UPER）显着降低，血清肌酐(Scr),血尿氮（BUN）和糖化血红蛋白（HbAlc）水平。在亚组分析中，联合黄芪和血管紧张素受体阻滞剂显著降低空腹血糖（FPG）和24h尿蛋白（24hUTP）水平，与黄芪和血管紧张素转换酶抑制剂联合治疗比较。同时,后者显着降低了尿微量蛋白（β2-MG）。重要的是,敏感性分析证实了研究的稳定性，UPER未检测到发表偏倚，BUN,HbAlc,FPG,或β2-MG。然而,TER,SCr,24hUTP结果提示可能的发表偏倚。
■黄芪-RAAS阻滞剂联合治疗是安全的，可改善预后；然而，严格随机，大规模,多中心,需要双盲试验来评估其在III期DN中的疗效和安全性.
肾素-血管紧张素-醛固酮系统（RAAS）抑制剂通常用于治疗糖尿病性神经病（DN），黄芪成分已知可改善DN症状。我们旨在建立黄芪与RAAS抑制剂联合使用的有效性和安全性。黄芪联合RAAS抑制剂可提高糖尿病神经病变治疗的总有效率，降低尿蛋白排泄率，血清肌酐,血尿素氮和HbAlc.敏感性分析确认了研究的稳定性，而发表偏倚被检测为总有效率，血清肌酐,和24小时尿蛋白水平。
