A Meta-analysis of Xuefu Zhuyu decoction combined with western medicine in the treatment of diabetic nephropathy

Objective To evaluate the efficacy of Xuefu Zhuyu decoction combined with western medicine in the treatment of diabetic nephropathy. Methods According to the international Cochrane collaboration system evaluation method, computer retrieval CNKI database, Wanfang series database and VIP Chinese science and technology periodicals database, the Chinese biomedical literature database, PubMed, Embase, and the Cochrane library databases combined with manual retrieval, the randomized controlled trials on Xuefu Zhuyu decoction combined with western medicine for the treatment of diabetic nephropathy were collected from the inception to May 1, 2017. The meta-analysis was performed using Revman 5.3 software for the literatures meeting the criteria. Results A total of 12 randomized controlled trials in China were included, with 1,014 cases of diabetic nephropathy. The meta-analysis showed Xuefu Zhuyu decoction combined with western medicine therapy was superior to pure western medicine in the treatment of diabetic nephropathy in lowering serum creatinine (MD=-48.11, 95%CI -59.18 to -37.03, P<0.01), urea nitrogen (MD=-1.38, 95%CI -1.86 to -0.89, P<0.01) and 24-h urinary protein quantity (SMD=-0.85, 95%CI -1.04 to -0.65, P<0.01), and improving the clinical total effective rate (OR=4.65, 95%CI 3.12 to 6.92, P<0.01). After treatment, the heterogeneity of urea nitrogen in ACEI group was significantly decreased as compared with non-ACEI group (P<0.01, I²=56%). Further reading literature, the incidence of adverse reactions in the two groups was not statistically significant. There was publication bias in the analysis of asymmetric "funnel plot" drawn by the total effective rate. Conclusions Xuefu Zhuyu decoction combined with western medicine therapy can significantly improve renal function, reduce urinary protein, improve the clinical total effective rate, and its combined use with ACEI drugs has better clinical efficacy in reducing urea nitrogen. However, due to the low quality of the literature included in the study, higher quality randomized controlled clinical trials are still needed to evaluate the clinical efficacy of Xuefu Zhuyu decoction in the treatment of diabetic nephropathy.