Tongxinluo Capsule for Diabetic Kidney Disease: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

1. Nursing Collge of Chongqing University of Medical Sciences Chongqoing 400016;2. Tibet Autonomous Region in Chengdu Office Hospital, Chengdu 610041;3. The Third hospital of Mianyang 621000;

Corresponding author：

Keywords：

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

DOI：

10.7507/1672-2531.20100179

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Objective 　To assess the efficacy of Tongxinluo for diabetic kidney disease.
Methods 　we conducted a systematic review of randomized controlled trials (RCTs) in which Tongxinluo was used to treat diabetic kidney disease. And we screened relevant studies according to predefined inclusion and exclusion criteria, evaluated the quality of the included studies, and performed meta-analyses by using The Cochrane Collaboration’s Revman 5.0 software.
Results 　A total of 11 RCTs were enrolled in the review. The results of meta-analysis showed that Tongxinluo was better on attenuating 24 hour urinary protein,BUN and UAER; Tongxinluo was not superior to no treatment on the improvement of Scr and Ccr; Tongxinluo was better than no treatment on the Regulation of blood lipids, such as TC, TG, LDL-C. However, Tongxinluo might have similar effects on the improvement of HDL-C; Tongxinluo was better than no treatment on the improvement of FBG, but xuezhikang was not superior to no treatment on the improvement of P2BG and HbA1c. Tongxinluo was better than no treatment in decreasing plasma endothelin (ET). No significant adverse effects or Allergic reactions were reported.
Conclusion 　The evidence currently available shows that Tongxinluo has some effect and is relatively safe in treating patients with diabetic kidney disease.Due to a high risk of selection bias and detection bias in the included studies, the evidence is insufficient to determine the effect of Tongxinluo. Further large-scale trials are required to define the role of xuezhikang in the treatment of DKD.

Citation： LONG Xuan,WANG Feng,HUANG Changquan. Tongxinluo Capsule for Diabetic Kidney Disease: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2010, 10(1): 73-80. doi: 10.7507/1672-2531.20100179 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, 83-84.
3.	Baynes JW, Thoroe SR. Role of oxidative stress in diabetic complications:a new perspective on an old paradigm. Diaetes, 1999, 48(1): 1-9.
4.	Dulop M. Aldose reductase and the role of the polyol pathway in diabetic nephropathy. Kidney Int, 2000, 77(suppl): S3-S12.
5.	吴以岭. 络病学基础与临床研究. 北京: 中国科学技术出版社, 2005, 142-145.
6.	Mogensen CE, Schmitz A, Christensen CK. Diabetes Metabolism Bev, 1998, 4: 453.
7.	梁社生, 王礼文, 冯学山. 厄贝沙坦与通心络联用对早期糖尿病肾病患者微量白蛋白尿的影响. 中国医师进修杂志, 2006, 29(11): 22-23, 26.
8.	孙世宁, 黄红芳. 通心络胶囊对早期糖尿病肾病患者血浆、尿内皮素的影响. 新中医, 2004, 36(4): 32-33.
9.	彭仙珍, 沈三英, 宋小红, 等. 缬沙坦联合通心络胶囊治疗糖尿病肾病的临床疗效分析. 医药导报, 2007, 26(3): 268-269.
10.	陈翠萍, 冯其斌. 蒙诺联合通心络胶囊治疗早期糖尿病肾病31例疗效观察. 新中医, 2008, 40(5): 27-28.
11.	林楠, 宋瑄, 薛丽. 通心络胶囊治疗糖尿病肾病疗效观察. 中国误诊学杂志, 2005, 5(9): 1663-1664.
12.	陈阳, 胡蕴刚, 朱福. 通心络胶囊联合依那普利治疗2型糖尿病肾病临床观察. 疑难病杂志, 2003, 2(5): 277-279.
13.	赵毅, 张显林. 通心络胶囊对糖尿病肾病患者血浆内皮素的影响. 中国中西医结合杂志, 2005, 25(2): 131-133.
14.	曹卫华, 周力, 王宇彬, 等. 通心络对糖尿病肾病尿白蛋白排泄率的影响. 潍坊医学院学报, 2005, 27(3): 176-177.
15.	刘燕妮, 陈毅平. 通心络联合缬沙坦治疗早期糖尿病肾病疗效观察. 中国医药导报, 2008, 5(21): 83-84.
16.	王玲琳, 沈世豪, 应培珍, 等. 氯沙坦联合通心络对2型糖尿病患者肾功能的影响. 疑难病杂志, 2007, 6(2): 85-87.
17.	张素英. 通心络胶囊治疗糖尿病肾病60例疗效观察. 络病学基础与临床研究, 2007, (3): 382-383.
18.	Mitch WE. Treating diabetic nephropathy--are there only economic issues? New England Journal of Medicine, 2004, 351(19): 1934-1936.
19.	王吉耀, 等. 内科学. 北京: 人民卫生出版社, 2005, 561-564.
20.	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.
21.	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.
22.	Parring HH, Osterby R, Anderson PW, et a1. Diabetic Nephropathy. In Brenner BM Ed. The Kidney Philadelphia, PA: w. B. Saunders. 1996, 1864-1892.
23.	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.
24.	KDOQI cl inical pract ice guidel ines and cl inical pract ice recommendations for diabetes and chronic kidney disease. NationalKidneyFoundation - Disease Specific Society. 2007 Feb. 179 pages.
25.	周旭平, 陆佩芳, 保勇. 临床常见肾脏疾病血浆内皮素水平的研究. 四川医学, 2002, 23(11): 1126-1127.
26.	张胜兰, 邢万佳, 晏辉, 等. 糖尿病肾病变病人血中一氧化氮与内皮素水平的观察. 中国糖尿病杂志, 1997, 5(4): 211-214.
27.	姜淑英, 林凡, 黄朝兴. 内皮素及其拮抗剂在糖尿病肾病中的作用. 中国中西医结合肾病杂志, 2007, 8(12): 744-745.

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, 83-84.
3. Baynes JW, Thoroe SR. Role of oxidative stress in diabetic complications:a new perspective on an old paradigm. Diaetes, 1999, 48(1): 1-9.
4. Dulop M. Aldose reductase and the role of the polyol pathway in diabetic nephropathy. Kidney Int, 2000, 77(suppl): S3-S12.
5. 吴以岭. 络病学基础与临床研究. 北京: 中国科学技术出版社, 2005, 142-145.
6. Mogensen CE, Schmitz A, Christensen CK. Diabetes Metabolism Bev, 1998, 4: 453.
7. 梁社生, 王礼文, 冯学山. 厄贝沙坦与通心络联用对早期糖尿病肾病患者微量白蛋白尿的影响. 中国医师进修杂志, 2006, 29(11): 22-23, 26.
8. 孙世宁, 黄红芳. 通心络胶囊对早期糖尿病肾病患者血浆、尿内皮素的影响. 新中医, 2004, 36(4): 32-33.
9. 彭仙珍, 沈三英, 宋小红, 等. 缬沙坦联合通心络胶囊治疗糖尿病肾病的临床疗效分析. 医药导报, 2007, 26(3): 268-269.
10. 陈翠萍, 冯其斌. 蒙诺联合通心络胶囊治疗早期糖尿病肾病31例疗效观察. 新中医, 2008, 40(5): 27-28.
11. 林楠, 宋瑄, 薛丽. 通心络胶囊治疗糖尿病肾病疗效观察. 中国误诊学杂志, 2005, 5(9): 1663-1664.
12. 陈阳, 胡蕴刚, 朱福. 通心络胶囊联合依那普利治疗2型糖尿病肾病临床观察. 疑难病杂志, 2003, 2(5): 277-279.
13. 赵毅, 张显林. 通心络胶囊对糖尿病肾病患者血浆内皮素的影响. 中国中西医结合杂志, 2005, 25(2): 131-133.
14. 曹卫华, 周力, 王宇彬, 等. 通心络对糖尿病肾病尿白蛋白排泄率的影响. 潍坊医学院学报, 2005, 27(3): 176-177.
15. 刘燕妮, 陈毅平. 通心络联合缬沙坦治疗早期糖尿病肾病疗效观察. 中国医药导报, 2008, 5(21): 83-84.
16. 王玲琳, 沈世豪, 应培珍, 等. 氯沙坦联合通心络对2型糖尿病患者肾功能的影响. 疑难病杂志, 2007, 6(2): 85-87.
17. 张素英. 通心络胶囊治疗糖尿病肾病60例疗效观察. 络病学基础与临床研究, 2007, (3): 382-383.
18. Mitch WE. Treating diabetic nephropathy--are there only economic issues? New England Journal of Medicine, 2004, 351(19): 1934-1936.
19. 王吉耀, 等. 内科学. 北京: 人民卫生出版社, 2005, 561-564.
20. 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.
21. 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.
22. Parring HH, Osterby R, Anderson PW, et a1. Diabetic Nephropathy. In Brenner BM Ed. The Kidney Philadelphia, PA: w. B. Saunders. 1996, 1864-1892.
23. 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.
24. KDOQI cl inical pract ice guidel ines and cl inical pract ice recommendations for diabetes and chronic kidney disease. NationalKidneyFoundation - Disease Specific Society. 2007 Feb. 179 pages.
25. 周旭平, 陆佩芳, 保勇. 临床常见肾脏疾病血浆内皮素水平的研究. 四川医学, 2002, 23(11): 1126-1127.
26. 张胜兰, 邢万佳, 晏辉, 等. 糖尿病肾病变病人血中一氧化氮与内皮素水平的观察. 中国糖尿病杂志, 1997, 5(4): 211-214.
27. 姜淑英, 林凡, 黄朝兴. 内皮素及其拮抗剂在糖尿病肾病中的作用. 中国中西医结合肾病杂志, 2007, 8(12): 744-745.

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