Combination therapy of tripterygium glycosides plus valsartan in diabetic nephropathy treatment: A systematic review and meta-analysis |
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| Institution: | 1. Department of Chemotherapy 2, Wenzhou Central Hospital, Wenzhou 325000, China;2. State Key Laboratory for Diagnosis and Treatment of Infectious Disease, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310000, China;3. Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou 310000, China;4. Department of Cardiology, The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou 325000, China;5. Zhuang Medical College, Guangxi University of Chinese Medicine, Nanning 530000, China;6. Department of Traditional Chinese Medicine, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou 325000, China;1. Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, Tehran 19839-63113, Iran;2. Department of Chemistry, Richardson College for the Environmental Science Complex, The University of Winnipeg, Winnipeg R3C 1 X 6, Canada;3. Department of Pharmacognosy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran 19839-63113, Iran;4. International Center for Chemical and Biological Sciences, H.E.J. Research Institute of Chemistry, University of Karachi, Karachi 75270, Pakistan;5. Reproductive Medicine Unit, University of Schleswig-Holstein, Luebeck 24105, Germany;6. Department of Medicinal Chemistry, Shaheed Beheshti School of Pharmacy, Tehran 19839-63113, Iran;7. Medical Plant Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord 14747-17531, Iran;8. Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran 14496-14535, Iran;1. Department of Hematology, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China;2. Department of Research, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China;3. Department of Dermatology, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China;4. Department of Clinical laboratory, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China;1. Hubei Key Laboratory of Biotechnology of Traditional Chinese Medicine, National & Local Joint Engineering Research Center of High-throughput Drug Screening Technology, Hubei University, Wuhan 430062, China;2. Hubei Key Laboratory of Tumor Microenvironment and Immunotherapy, Medical College of China Three Gorges University, Yichang 443000, China |
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| Abstract: | ObjectiveTo assess the efficacy and safety of the combination therapy of Chinese herbal medicines, tripterygium glycosides, plus valsartan for the treatment of diabetic nephropathy (DN).MethodsA comprehensive research of 12 electronic databases was performed. Data of the included studies were extracted and analyzed independently by two authors, and were synthesized using Review Manager (version 5.2) and Stata (version 12.0).ResultsA total of 12 randomized controlled trials (RCTs) involving 829 patients were included. Pooled results showed that the combination therapy significantly increased total efficacy of DN patients RR = 1.35, 95% CI (1.22, 1.50), P < 0.001], the level of serum albumin Mean difference (MD) = 3.87, 95% CI (3.12, 4.62), P < 0.001], and significantly decreased 24 h urinary protein level MD = −0.97, 95% CI (−1.19, −0.76), P < 0.001], urinary albumin-excretion rate MD = −145.53, 95% CI (−227.95, −63.11), P < 0.001], and urinary β2-microglobuli level MD = −11.86, 95% CI (−13.02, −10.69), P < 0.001]. No significant differences were found in levels of serum creatinine MD = −0.26, 95% CI (−7.52, 7.00), P > 0.05), blood urea nitrogen MD = 0.25, 95% CI (−0.23, 0.74), P > 0.05], and endogenous creatinine clearance rate MD = −0.43, 95% CI (−3.48, 2.62), P > 0.05]. However, tripterygium glycosides plus valsartan seemed to exert higher adverse reaction rate than valsartan monotherapy MD = 3.41, 95% CI (1.34, 8.66), P < 0.05]. There were no publication bias for all of the pooled effect sizes.ConclusionCombination therapy of tripterygium glycosides plus valsartan may be effective for the treatment of DN. However, the safety of the combination therapy need to be further confirmed. |
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