Safety and Effectiveness of Traditional Chinese Medicine Compound in Treating Idiopathic Membranous Nephropathy Network Meta-analysis
Keywords:
Compound Chinese medicine, Idiopathic membranous nephropathy, Mesh Meta-analysis, 24hUTP, ALB, PLA2R, SCr, TCAbstract
Objective: To evaluate the clinical effectiveness and safety of different traditional Chinese medicine prescriptions combined with conventional western drugs to improve idiopathic membranous nephropathy (IMN) based on the Chinese medicine evidence system. METHODS: A computerized search of eight databases, including China Knowledge Network (CNKI), Wanfang, PubMed, and Web of Science, was conducted to collect randomized controlled trials (RCTs) of TCM compound formulas combined with conventional western medicines for the treatment of IMN, with a search timeframe of the period from the establishment of the database to 2023 October. The quality of the included literature was evaluated using the Cochrane Risk of Bias Assessment Tool version 2.0 (RoB2.0), reticulated Meta-analysis was performed using Stata 18.0 software, and the area under the cumulative ranking curve was used to rank the clinical efficacy and safety of the six interventions, with the aim of providing an evidence-based basis for the rational clinical selection of prescriptions for treating patients with IMN. RESULTS: Thirty-five RCTs involving 6 interventions and containing 2518 IMN patients were finally included. CONCLUSION: Thirty-five papers involving 2518 patients were finally included in the literature. The effect of the formula of tonifying deficiency and eliminating stasis + conventional western medicine was significant in lowering 24-hour urine protein quantification (SUCRA: 95.3%) and total cholesterol level (SUCRA: 98.2%); the formula of tonifying deficiency, eliminating stasis and dispelling dampness + conventional western medicine (SUCRA: 71.2%) was more effective in increasing the total effective rate; and the formula of tonifying deficiency, eliminating stasis and purging heat and dispelling dampness + conventional Western medicine was effective in lowering blood creatinine ( SUCRA: 80.4%) and increased serum albumin level (SUCRA: 72.9%), while the formula for tonifying deficiency and clearing heat and dampness and conventional western medicine was more effective in lowering M-type phospholipase A2 receptor antibody titer (SUCRA: 86.0%). In terms of safety, the adverse effects of the TCM compound formula combined with conventional western drugs were overall less than those of conventional western drugs alone. The overall quality of the included RCTs was low, and more rigorous, large-sample size RCTs and basic studies are needed to verify the clinical applicability.
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