Xuezhikang for Diabetic Kidney Disease: A Systematic Review of Randomized Controlled Trials_Chinese Journal of Evidence-Based Medicine

Authors：

WANG Feng ,  WU Hongmei

Department of Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

WU Hongmei, Email: drwhm@163.com

Keywords：

Xuezhikang; Diabetic kidney disease; Randomized controlled trial; Systematic review; Meta-analysis

DOI：

10.7507/1672-2531.20090014

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective 　To assess the effectiveness of xuezhikang for treating diabetic kidney disease.
Methods 　We searched the Cochrane Central Register of Controlled Trials (Issue 3, 2008), MEDLINE (1980 to September 2008), EMbase (1980 to September 2008), CBMdisc (1990 to September 2008), and CNKI (1994 to September 2008). We also hand searched relevant journals and conference proceedings. Randomized controlled trials (RCTs) in which xuezhikang was used to treat diabetic kidney disease were collected. Then we screened the retrieved studies according to predefined inclusion and exclusion criteria, evaluated the quality of included studies, and performed metaanalyses by using The Cochrane Collaboration’s RevMan 4.2 software.
Results 　Nine RCTs were included. Meta-analyses showed that xuezhikang was superior to routine treatment in decreasing 24-hour urinary protein (WMD –0.87, 95%CI –1.34 to –0.41), microalbuminuria (WMD –115.39, 95%CI –127.63 to –103.15), and urinary albumin excretion rate (WMD – 65.46, 95%CI –68.87 to –62.12); but xuezhikang had similar effects in reducing serum creatinine compared with routine treatment (WMD –5.42, 95%CI –11.06 to 0.21). Moreover, xuezhikang was more effective in regulating blood lipids, including TC (WMD –1.71, 95%CI –2.39 to –1.03), TG (WMD –0.96, 95%CI –1.46 to –0.46), LDL-C (WMD –1.01, 95%CI –1.64 to –0.38), and HDL-C (WMD 0.22, 95%CI 0.09 to 0.36). Xuezhikang was not superior to routine treatment in improving fasting blood sugar (WMD -0.01, 95%CI -0.49 to 0.47), but was more effective in improving 2 h-BS (WMD –1.10, 95%CI –1.35 to –0.85) and HbA1c (WMD –0.41, 95%CI –0.56 to –0.27). No significant adverse effects or allergic reactions were reported.
Conclusions 　 The evidence currently available shows that xuezhikang may decrease 24-hour urinary protein, microalbuminuria, serum creatinine, regulate blood lipids, and adjust blood glucose. Due to a high risk of selection bias and detection bias in the included studies, the evidence is insufficient to determine the effect of xuezhikang. Further large-scale trials are required to define the role of xuezhikang in the treatment of diabetic kidney disease.

Citation： WANG Feng,WU Hongmei. Xuezhikang for Diabetic Kidney Disease: A Systematic Review of Randomized Controlled Trials. Chinese Journal of Evidence-Based Medicine, 2009, 09(1): 63-70. doi: 10.7507/1672-2531.20090014 Copy

1.	Caramori ML, Mauer M. Diabetes and nephropathy. Curr Opin Nephrol Hypertens, 2003, 12: 273-282.
2.	郑法雷, 章友康, 陈香美, 等. 肾脏病临床与进展. 北京人民军医出版社, 2005, p83-84.
3.	寇文锫. 血脂康基础与临床概述. 中华内科杂志, 1998, 37(6): 364.
4.	Mogensen CE, Schmitz A, Christensen CK. Diabetes Metabolism Bev. 1998, 4: 453.
5.	Alderson P, Green S, Higgins JPT. Cochrane Reviewers’Handbook 4.2.2[updated March 2004]. In: The Cochrane Library,Issue 1,2004.
6.	吉桂萍, 武景连. 血脂康胶囊治疗早期糖尿病肾病32例. 中国厂矿医学, 2007, 20(3): 226-227.
7.	李红, 郑姜钦, 吕绍光. 血脂康对伴微量白蛋白尿的2型糖尿病高脂血症的疗效观察. 福建医药杂志, 2005, 27(5): 60-61.
8.	王露, 史亮, 韩玲玲. 血脂康对2型糖尿病肾病合并高脂血症患者及尿蛋白的影响. 实用糖尿病杂志, 2006, 2(1): 18-19.
9.	金劼, 张伟文, 何援军, 等. 血脂康治疗血脂异常的糖尿病肾病60例临床观察. 浙江医学, 2007, 29(9): 973-974.
10.	何玲, 谌剑飞. 血脂康调脂治疗对2型糖尿病患者尿微量白蛋白的影响. 中国慢性病预防与控制, 2008, 16(2): 191-192.
11.	黄宇清, 邹亦平, 罗红娥. 血脂康治疗糖尿病肾病疗效分析. 辽宁中医药大学学报, 2008, 10(8): 93-94.
12.	姚莉, 范艳. 血脂康治疗糖尿病肾病高脂血症的疗效观察. 齐鲁护理杂志, 2006, 12(5): 797-798.
13.	丁俊蓉, 周益伟, 许华强. 血脂康对2型糖尿病肾病血脂和微量白蛋白的影响. 现代中西医结合杂志, 2008, 17(10): 1461-1462.
14.	王露, 吴日娜. 血脂康对2型糖尿病肾病微量白蛋白的影响. 临床内科杂志, 2007, 24(4): 269-270.
15.	Mitch WE. Treating diabetic nephropathy--are there only economic issues? New England Journal of Medicine, 2004, 351(19): 1934-1936.
16.	王吉耀, 等. 内科学. 北京: 人民卫生出版社, 2005, 561.
17.	Hung CC, Yinn YG, Shyi TS, et al. Insulin and heparin suppress superoxide production in diabetic rat glomeruli stimulated with lowdensity lipoprotein. Kidney, 2001, 59(supp1): 124.
18.	李学旺, 等. 调脂治疗对肾小球疾病的保护作用. 中国实用内科杂志, 2003, 23(5): 311.
19.	Parring HH, Osterby R, Anderson PW, et a1. Diabetic Nephropathy. In Brenner BM Ed. The Kidney Philadelphia, PA: w.B.Saunders, 1996, 1864-1892.
20.	Di Paolo S, Gesualdo L, Ranieri E, et a1. High glucose concentration induces the overexpression of transfotruing growth factor- beta through the activation of platelet -derived growth factor loop in human mesangial cells. American Journal of Pathology, 1996, 149(6): 2095-2106.
21.	KDOQI cl inical pract ice guidel ines and cl inical pract ice recommendations for diabetes and chronic kidney disease. National Kidney Foundation - Disease Specific Society, 2007, (2): 179.

1. Caramori ML, Mauer M. Diabetes and nephropathy. Curr Opin Nephrol Hypertens, 2003, 12: 273-282.
2. 郑法雷, 章友康, 陈香美, 等. 肾脏病临床与进展. 北京人民军医出版社, 2005, p83-84.
3. 寇文锫. 血脂康基础与临床概述. 中华内科杂志, 1998, 37(6): 364.
4. Mogensen CE, Schmitz A, Christensen CK. Diabetes Metabolism Bev. 1998, 4: 453.
5. Alderson P, Green S, Higgins JPT. Cochrane Reviewers’Handbook 4.2.2[updated March 2004]. In: The Cochrane Library,Issue 1,2004.
6. 吉桂萍, 武景连. 血脂康胶囊治疗早期糖尿病肾病32例. 中国厂矿医学, 2007, 20(3): 226-227.
7. 李红, 郑姜钦, 吕绍光. 血脂康对伴微量白蛋白尿的2型糖尿病高脂血症的疗效观察. 福建医药杂志, 2005, 27(5): 60-61.
8. 王露, 史亮, 韩玲玲. 血脂康对2型糖尿病肾病合并高脂血症患者及尿蛋白的影响. 实用糖尿病杂志, 2006, 2(1): 18-19.
9. 金劼, 张伟文, 何援军, 等. 血脂康治疗血脂异常的糖尿病肾病60例临床观察. 浙江医学, 2007, 29(9): 973-974.
10. 何玲, 谌剑飞. 血脂康调脂治疗对2型糖尿病患者尿微量白蛋白的影响. 中国慢性病预防与控制, 2008, 16(2): 191-192.
11. 黄宇清, 邹亦平, 罗红娥. 血脂康治疗糖尿病肾病疗效分析. 辽宁中医药大学学报, 2008, 10(8): 93-94.
12. 姚莉, 范艳. 血脂康治疗糖尿病肾病高脂血症的疗效观察. 齐鲁护理杂志, 2006, 12(5): 797-798.
13. 丁俊蓉, 周益伟, 许华强. 血脂康对2型糖尿病肾病血脂和微量白蛋白的影响. 现代中西医结合杂志, 2008, 17(10): 1461-1462.
14. 王露, 吴日娜. 血脂康对2型糖尿病肾病微量白蛋白的影响. 临床内科杂志, 2007, 24(4): 269-270.
15. Mitch WE. Treating diabetic nephropathy--are there only economic issues? New England Journal of Medicine, 2004, 351(19): 1934-1936.
16. 王吉耀, 等. 内科学. 北京: 人民卫生出版社, 2005, 561.
17. Hung CC, Yinn YG, Shyi TS, et al. Insulin and heparin suppress superoxide production in diabetic rat glomeruli stimulated with lowdensity lipoprotein. Kidney, 2001, 59(supp1): 124.
18. 李学旺, 等. 调脂治疗对肾小球疾病的保护作用. 中国实用内科杂志, 2003, 23(5): 311.
19. Parring HH, Osterby R, Anderson PW, et a1. Diabetic Nephropathy. In Brenner BM Ed. The Kidney Philadelphia, PA: w.B.Saunders, 1996, 1864-1892.
20. Di Paolo S, Gesualdo L, Ranieri E, et a1. High glucose concentration induces the overexpression of transfotruing growth factor- beta through the activation of platelet -derived growth factor loop in human mesangial cells. American Journal of Pathology, 1996, 149(6): 2095-2106.
21. KDOQI cl inical pract ice guidel ines and cl inical pract ice recommendations for diabetes and chronic kidney disease. National Kidney Foundation - Disease Specific Society, 2007, (2): 179.

Chinese Journal of Evidence-Based Medicine

Xuezhikang for Diabetic Kidney Disease: A Systematic Review of Randomized Controlled Trials

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content