Journal of Traditional Chinese Medicine ›› 2023, Vol. 43 ›› Issue (3): 429-440.DOI: 10.19852/j.cnki.jtcm.20230308.003
• Meta-analysises • Next Articles
Efficacy and safety of activating blood circulation and removing blood stasis of Traditional Chinese Medicine for managing renal fibrosis in patients with chronic kidney disease: a systematic review and Meta-analysis
LUO Xin1,2, XIE Jing1,2, HUANG Li1,2, GAN Wenfan1,2, CHEN Ming1,2(
)
- 1 Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610072, China
2 Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
-
Received:2021-11-02Accepted:2022-05-18Online:2023-06-15Published:2023-03-08 -
Contact:Prof. CHEN Ming, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610072, China; Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China. cm632381745@163.com. Telephone: +86-18980880236 -
Supported by:Optimization and Evaluation of Clinical Scheme of Traditional Chinese Medicine for Delaying the Progression of Chronic Kidney Disease by Fuzhenghuayu Jiangzhuo tongluo Principle(2021YFS0034);Studies on Mechanism of Bupiyishen Tongfu Xiezhuo Principle in Delaying the Progression of Chronic Kidney Disease in Rats by Adjusting Host Metabonomics and Gut Microbiota with Multi-omics Technology(81973673)
Cite this article
LUO Xin, XIE Jing, HUANG Li, GAN Wenfan, CHEN Ming. Efficacy and safety of activating blood circulation and removing blood stasis of Traditional Chinese Medicine for managing renal fibrosis in patients with chronic kidney disease: a systematic review and Meta-analysis[J]. Journal of Traditional Chinese Medicine, 2023, 43(3): 429-440.
share this article
Figure 1 Study flow diagram CNKI: China national knowledge infrastructure database; Wanfang Data: Wanfang knowledge service platform; VIP: China science and technology journal database; Sinomed: Chinese biomedical literature database; CENTRAL: the Cochrane Central Register of Controlled Trials; Embase: Excerpt medica database; TCM: Traditional Chinese Medicine; ARTCM: activating blood circulation and removing blood stasis in terms of TCM.
Figure 1 Study flow diagram CNKI: China national knowledge infrastructure database; Wanfang Data: Wanfang knowledge service platform; VIP: China science and technology journal database; Sinomed: Chinese biomedical literature database; CENTRAL: the Cochrane Central Register of Controlled Trials; Embase: Excerpt medica database; TCM: Traditional Chinese Medicine; ARTCM: activating blood circulation and removing blood stasis in terms of TCM.
Table 1 Details of the included studies
| Study | Diagnostic criteria | Sample size (n) | Sample size (n) | Gender (M/F) | Age (range or mean±SD) (years) | Intervention | Duration | Outcome | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WM | TCM syndrome pattern | T/C | Treatment | Control | |||||||||||||||||
| Chen BM et al 202042 | CKD G2 | Dampness turbidity pattern and blood stasis pattern | 254 | 127/127 | T: 57/70 C: 56/71 | T: 20-63(44.60) C: 21-62(43.72) | WM+Paidu Baoshen pill (6 g/bag), 3 g, bid, po | WM | 12 w | ⑤⑥ | |||||||||||
| Gao L 201243 | CRF | NM | 30 | 15/15 | T: 6/9 C: 7/8 | T: 42.11±13.06 C: 42.6±12.76 | WM+Zishen Huoxue recipe decoction, one dose a day, half dose of decoction once, bid, po | WM | 8 w | ④⑥⑦⑧ | |||||||||||
| Han HY et al 201644 | CKD G3-G4 | NM | 60 | 30/30 | T: 17/13 C: 16/14 | T: 43.36±9.34 C: 42.57±10.67 | WM+Ye's renal failure Party A, one dose a day, 100 mL once, bid, po | WM | 6 m | ⑤⑥⑦⑧ | |||||||||||
| Hu XM 200545 | CKD | Kidney deficiency pattern, blood stasis pattern | 60 | 31/29 | T: 14/17 C：13/16 | T: 36.85±14.95 C: 35.59±15.63 | WM+Zishenhuoxue Recipe Corpuscles, one dose a day, half dose of granule once, bid, po | WM+Captopril Tablets, 25 mg, tid, po | 2 m | ②③④⑥⑦ | |||||||||||
| Huang DH et al 201732 | CGN | Qi deficiency and blood stasis pattern | 140 | 70/70 | T: 38/32 C: 41/29 | T: 50.8±12.6 C: 51.2±13.3 | WM+modified Shenluotong decoction, one dose a day, 200 mL once, bid, po | WM | 16 w | ①②③⑤⑥⑦⑧ | |||||||||||
| Hu XM et al 202134 | CKD G2-G4 | Kidney deficiency and blood stasis pattern | 68 | 34/34 | T: 20/14 C: 18/16 | T: 45.85±14.95 C: 46.59±15.63 | WM+Bushen Huoxue granule (25 g/bag), 25 g, bid, po | WM | 4 m | ②③④⑥⑦ | |||||||||||
| Jin YM et al 200933 | CGN | Blood stasis pattern | 108 | 72/36 | 51/57 | 18-65(52.45) | WM+Dahuang Zhechong Wan, 3 g, bid, po | WM | 4 m | ②③④⑥⑦⑧ | |||||||||||
| Li J, Li YH 201546 | CRF | NM | 80 | 40/40 | T: 25/15 C: 21/19 | T: 63.4 ±3.6 C: 63.8±3.8 | WM+Modified Buyang Huanwu decoction, one dose a day, half-dose of decoction once, bid, po | WM | 6w | ①②③④⑥⑦ | |||||||||||
| Li KK et al 201547 | CKD G3 | Pattern of kidney collateral stasis | 48 | 24/24 | T: 15/9 C: 14/10 | T: 49.35±11.12 C: 48.79±10.87 | WM+Huoxue Tongluo granule, 1 bag, bid, po | WM | 12w | ①②③④⑥⑦ | |||||||||||
| Liu JY et al 200731 | CGN | Spleen-kidney Qi deficiency pattern and blood stasis pattern | 60 | 30/30 | T: 12/18 C: 11/19 | T: 41.3±2.2 C: 39.8 ±2.8 | WM+Yiqi Huoxue Huayu decoction (10 mL/piece), 10-20 mL, tid, po | WM | 3 m | ②③④⑥⑧ | |||||||||||
| Ren F, Zhou JJ 201348 | CKD phase II- III | NM | 60 | 30/30 | NM | NM | WM+Huoshen Tongluo recipe, one dose a day, 100 mL once, bid, po | WM+Losartan Potassium Tablets, 50 mg, qd, po | 3 m | ④⑥⑦⑧ | |||||||||||
| Wang Y et al 200249 | CRF | NM | 90 | 60/30 | T: 32/28 C: 17/13 | T: 27-76(53.1) C: 30-73(48.8) | WM+Resisting-fibrosis agent (10 g/bag), 10 g, tid, po | WM+Coated Aldehyde Oxystarch, 5 g, tid, po | 2 m | ②③④⑥⑦ | |||||||||||
| Xiang SW et al 200650 | Period of azotemia and renal failure | NM | 72 | 36/36 | T: 21/15 C: 23/13 | T: 41.3±14.4 C: 39.4±17.1 | WM+Shenankang granule,1 bag, bid, po | WM | 2 m | ②③④⑥⑦ | |||||||||||
| Zhang CM et al 201353 | CKD3-4 | NM | 120 | 60/60 | T: 26/34 C: 27/33 | T: 27-82(64.1) C: 30-83(68.7) | WM+Kangxianling formula, po | WM+Losartan 50-100 mg, qd, po | 16w | ⑤⑥⑦⑧ | |||||||||||
| Zhong D 200651 | CGN | Qi deficiency pattern, blood stasis pattern | 60 | 30/30 | T: 12/18 C: 11/19 | T: 41.27±2.25 C: 39.83±2.81 | WM+Tongmai oral liquid, 10 mL, tid, po | WM | 3 m | ②③④⑥⑧ | |||||||||||
| Zhong D et al 201252 | Chronic renal insufficiency | Qi deficiency and blood stasis pattern | 60 | 30/30 | NM | NM | WM+Huangqi Danshen mixture, one dose a day, half-dose of mixture once, bid, po | WM | 3 m | ②③④⑥⑧ | |||||||||||
Table 1 Details of the included studies
| Study | Diagnostic criteria | Sample size (n) | Sample size (n) | Gender (M/F) | Age (range or mean±SD) (years) | Intervention | Duration | Outcome | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WM | TCM syndrome pattern | T/C | Treatment | Control | |||||||||||||||||
| Chen BM et al 202042 | CKD G2 | Dampness turbidity pattern and blood stasis pattern | 254 | 127/127 | T: 57/70 C: 56/71 | T: 20-63(44.60) C: 21-62(43.72) | WM+Paidu Baoshen pill (6 g/bag), 3 g, bid, po | WM | 12 w | ⑤⑥ | |||||||||||
| Gao L 201243 | CRF | NM | 30 | 15/15 | T: 6/9 C: 7/8 | T: 42.11±13.06 C: 42.6±12.76 | WM+Zishen Huoxue recipe decoction, one dose a day, half dose of decoction once, bid, po | WM | 8 w | ④⑥⑦⑧ | |||||||||||
| Han HY et al 201644 | CKD G3-G4 | NM | 60 | 30/30 | T: 17/13 C: 16/14 | T: 43.36±9.34 C: 42.57±10.67 | WM+Ye's renal failure Party A, one dose a day, 100 mL once, bid, po | WM | 6 m | ⑤⑥⑦⑧ | |||||||||||
| Hu XM 200545 | CKD | Kidney deficiency pattern, blood stasis pattern | 60 | 31/29 | T: 14/17 C：13/16 | T: 36.85±14.95 C: 35.59±15.63 | WM+Zishenhuoxue Recipe Corpuscles, one dose a day, half dose of granule once, bid, po | WM+Captopril Tablets, 25 mg, tid, po | 2 m | ②③④⑥⑦ | |||||||||||
| Huang DH et al 201732 | CGN | Qi deficiency and blood stasis pattern | 140 | 70/70 | T: 38/32 C: 41/29 | T: 50.8±12.6 C: 51.2±13.3 | WM+modified Shenluotong decoction, one dose a day, 200 mL once, bid, po | WM | 16 w | ①②③⑤⑥⑦⑧ | |||||||||||
| Hu XM et al 202134 | CKD G2-G4 | Kidney deficiency and blood stasis pattern | 68 | 34/34 | T: 20/14 C: 18/16 | T: 45.85±14.95 C: 46.59±15.63 | WM+Bushen Huoxue granule (25 g/bag), 25 g, bid, po | WM | 4 m | ②③④⑥⑦ | |||||||||||
| Jin YM et al 200933 | CGN | Blood stasis pattern | 108 | 72/36 | 51/57 | 18-65(52.45) | WM+Dahuang Zhechong Wan, 3 g, bid, po | WM | 4 m | ②③④⑥⑦⑧ | |||||||||||
| Li J, Li YH 201546 | CRF | NM | 80 | 40/40 | T: 25/15 C: 21/19 | T: 63.4 ±3.6 C: 63.8±3.8 | WM+Modified Buyang Huanwu decoction, one dose a day, half-dose of decoction once, bid, po | WM | 6w | ①②③④⑥⑦ | |||||||||||
| Li KK et al 201547 | CKD G3 | Pattern of kidney collateral stasis | 48 | 24/24 | T: 15/9 C: 14/10 | T: 49.35±11.12 C: 48.79±10.87 | WM+Huoxue Tongluo granule, 1 bag, bid, po | WM | 12w | ①②③④⑥⑦ | |||||||||||
| Liu JY et al 200731 | CGN | Spleen-kidney Qi deficiency pattern and blood stasis pattern | 60 | 30/30 | T: 12/18 C: 11/19 | T: 41.3±2.2 C: 39.8 ±2.8 | WM+Yiqi Huoxue Huayu decoction (10 mL/piece), 10-20 mL, tid, po | WM | 3 m | ②③④⑥⑧ | |||||||||||
| Ren F, Zhou JJ 201348 | CKD phase II- III | NM | 60 | 30/30 | NM | NM | WM+Huoshen Tongluo recipe, one dose a day, 100 mL once, bid, po | WM+Losartan Potassium Tablets, 50 mg, qd, po | 3 m | ④⑥⑦⑧ | |||||||||||
| Wang Y et al 200249 | CRF | NM | 90 | 60/30 | T: 32/28 C: 17/13 | T: 27-76(53.1) C: 30-73(48.8) | WM+Resisting-fibrosis agent (10 g/bag), 10 g, tid, po | WM+Coated Aldehyde Oxystarch, 5 g, tid, po | 2 m | ②③④⑥⑦ | |||||||||||
| Xiang SW et al 200650 | Period of azotemia and renal failure | NM | 72 | 36/36 | T: 21/15 C: 23/13 | T: 41.3±14.4 C: 39.4±17.1 | WM+Shenankang granule,1 bag, bid, po | WM | 2 m | ②③④⑥⑦ | |||||||||||
| Zhang CM et al 201353 | CKD3-4 | NM | 120 | 60/60 | T: 26/34 C: 27/33 | T: 27-82(64.1) C: 30-83(68.7) | WM+Kangxianling formula, po | WM+Losartan 50-100 mg, qd, po | 16w | ⑤⑥⑦⑧ | |||||||||||
| Zhong D 200651 | CGN | Qi deficiency pattern, blood stasis pattern | 60 | 30/30 | T: 12/18 C: 11/19 | T: 41.27±2.25 C: 39.83±2.81 | WM+Tongmai oral liquid, 10 mL, tid, po | WM | 3 m | ②③④⑥⑧ | |||||||||||
| Zhong D et al 201252 | Chronic renal insufficiency | Qi deficiency and blood stasis pattern | 60 | 30/30 | NM | NM | WM+Huangqi Danshen mixture, one dose a day, half-dose of mixture once, bid, po | WM | 3 m | ②③④⑥⑧ | |||||||||||
Table 2 Sensitivity analysis for ARTCM + WM vs WM
| Outcome | Study (n) | Sample | Summary of statistics | ||||||
|---|---|---|---|---|---|---|---|---|---|
| R = 0.25 | R = 0.5 | R = 0.75 | |||||||
| T | C | MD/SMD | 95% CI | MD/SMD | 95%CI | MD/SMD | 95% CI | ||
| HA | 3 | 129 | 127 | -0.60 | -1.57, 0.36 | -0.74 | -1.91, 0.44 | -1.02 | -2.66, 0.63 |
| C-IV | 12 | 413 | 345 | -1.82 | -2.56, -1.08 | -2.17 | -3.01, -1.34 | -2.87 | -3.89, -1.86 |
| PC-III | 11 | 434 | 364 | -0.91 | -1.41, -0.40 | -1.08 | -1.64, -0.53 | -1.45 | -2.11, -0.79 |
| LN | 11 | 434 | 364 | -1.06 | -1.38, -0.74 | -1.28 | -1.65, -0.90 | -1.71 | -2.20, -1.23 |
| TGF-β1 | 4 | 282 | 280 | -0.54 | -0.98, -0.10 | -0.65 | -1.18, -0.12 | -0.90 | -1.62, -0.17 |
| SCR | 16 | 713 | 643 | -1.18 | -1.63, -0.72 | -1.36 | -1.85, -0.87 | -1.69 | -2.23, -1.15 |
| BUN | 12 | 496 | 426 | -1.44 | -2.55, -0.34 | -1.51 | -2.59, -0.43 | -1.60 | -2.64, -0.56 |
| 24hUpro | 9 | 361 | 323 | -1.02 | -1.66, -0.38 | -1.23 | -1.96, -0.50 | -1.24 | -1.96, -0.52 |
Table 2 Sensitivity analysis for ARTCM + WM vs WM
| Outcome | Study (n) | Sample | Summary of statistics | ||||||
|---|---|---|---|---|---|---|---|---|---|
| R = 0.25 | R = 0.5 | R = 0.75 | |||||||
| T | C | MD/SMD | 95% CI | MD/SMD | 95%CI | MD/SMD | 95% CI | ||
| HA | 3 | 129 | 127 | -0.60 | -1.57, 0.36 | -0.74 | -1.91, 0.44 | -1.02 | -2.66, 0.63 |
| C-IV | 12 | 413 | 345 | -1.82 | -2.56, -1.08 | -2.17 | -3.01, -1.34 | -2.87 | -3.89, -1.86 |
| PC-III | 11 | 434 | 364 | -0.91 | -1.41, -0.40 | -1.08 | -1.64, -0.53 | -1.45 | -2.11, -0.79 |
| LN | 11 | 434 | 364 | -1.06 | -1.38, -0.74 | -1.28 | -1.65, -0.90 | -1.71 | -2.20, -1.23 |
| TGF-β1 | 4 | 282 | 280 | -0.54 | -0.98, -0.10 | -0.65 | -1.18, -0.12 | -0.90 | -1.62, -0.17 |
| SCR | 16 | 713 | 643 | -1.18 | -1.63, -0.72 | -1.36 | -1.85, -0.87 | -1.69 | -2.23, -1.15 |
| BUN | 12 | 496 | 426 | -1.44 | -2.55, -0.34 | -1.51 | -2.59, -0.43 | -1.60 | -2.64, -0.56 |
| 24hUpro | 9 | 361 | 323 | -1.02 | -1.66, -0.38 | -1.23 | -1.96, -0.50 | -1.24 | -1.96, -0.52 |
Figure 2 Risk of bias and summary A: risk of bias: B: risk of summary.
Figure 2 Risk of bias and summary A: risk of bias: B: risk of summary.
Figure 3 Results of the Meta-analysis A: forest plot of HA; B: forest plot of C-Ⅳ; C: forest plot of PC-Ⅲ; D: forest plot of LN; E: forest plot of LN (duration of 8 and 12 weeks); F: forest plot of LN (duration of 16 and 24 weeks). HA: hyaluronic acid; C-IV: type IV collagen; PC-Ⅲ: type Ⅲ procollagen; LN: laminin; WM: Western Medicine; ARTCM: activating blood circulation and removing blood stasis in terms of Traditional Chinese Medicine; SD: standard deviation; IV: inverse variance; CI: confidence interval; Std. mean difference: standardised mean difference; Random: random-effects model; Fixed: fixed-effects model.
Figure 3 Results of the Meta-analysis A: forest plot of HA; B: forest plot of C-Ⅳ; C: forest plot of PC-Ⅲ; D: forest plot of LN; E: forest plot of LN (duration of 8 and 12 weeks); F: forest plot of LN (duration of 16 and 24 weeks). HA: hyaluronic acid; C-IV: type IV collagen; PC-Ⅲ: type Ⅲ procollagen; LN: laminin; WM: Western Medicine; ARTCM: activating blood circulation and removing blood stasis in terms of Traditional Chinese Medicine; SD: standard deviation; IV: inverse variance; CI: confidence interval; Std. mean difference: standardised mean difference; Random: random-effects model; Fixed: fixed-effects model.
Figure 4 Results of the Meta-analysis A: forest plot of TGF-β1; B: forest plot of Scr; C: forest plot of BUN; D: forest plot of 24hUpro: E: forest plot of BUN (duration of 8 and 16 weeks); F: forest plot of BUN (duration of 12 and 24 weeks). TGF-β1: trans-forming growth factor β1; Scr: serum creatinine; BUN: blood urea nitrogen; 24hUpro: 24 h urine protein; WM: Western Medicine; ARTCM: activating blood circulation and removing blood stasis in terms of Traditional Chinese Medicine; SD: standard deviation; IV: inverse variance; CI: confidence interval; Std. mean difference: standardised mean difference; Random: random-effects model; Fixed: fixed-effects model.
Figure 4 Results of the Meta-analysis A: forest plot of TGF-β1; B: forest plot of Scr; C: forest plot of BUN; D: forest plot of 24hUpro: E: forest plot of BUN (duration of 8 and 16 weeks); F: forest plot of BUN (duration of 12 and 24 weeks). TGF-β1: trans-forming growth factor β1; Scr: serum creatinine; BUN: blood urea nitrogen; 24hUpro: 24 h urine protein; WM: Western Medicine; ARTCM: activating blood circulation and removing blood stasis in terms of Traditional Chinese Medicine; SD: standard deviation; IV: inverse variance; CI: confidence interval; Std. mean difference: standardised mean difference; Random: random-effects model; Fixed: fixed-effects model.
| [1] |
GBD chronic kidney disease collaboration. Global, regional, and national burden of chronic kidney disease,1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2020; 395: 709-33.
DOI URL |
| [2] |
Xu H, Wu T, Huang L. Therapeutic and delivery strategies of phytoconstituents for renal fibrosis. Adv Drug Deliv Rev 2021; 177: 113911.
DOI URL |
| [3] |
Djudjaj S, Boor P. Cellular and molecular mechanisms of kidney fibrosis. Mol Aspects Med 2019; 65: 16-36.
DOI PMID |
| [4] | Zhang W, Gu JJ. An analysis of classification and etiolgy and pathogenesis of nephropathy in Arcane Essentials from the Imperial Library. Henan Zhong Yi 2019; 39: 668-71. |
| [5] | Zhang ZC Qing dynasty. Huang Di Nei Jing Ling Shu Ji Zhu. Hangzhou: Zhejiang Ancient Books Publishing House, 2002: 58-72. |
| [6] | Chen KJ, Shi ZX, Practical blood stasis syndrome pattern. Beijing: People's Health Publishing House, 1999: 438. |
| [7] | Zhu DX Yuan dynasty. Dan Xi Xin Fa. Beijing: China Press of Traditional Chinese Medicine, 2008: 160-5. |
| [8] | Tang RC Qing dynasty. Xue Zheng Lun. Beijing: China Press of Traditional Chinese Medicine, 1996: 115. |
| [9] | Wu YL. Discussion on the correlation between "collateral-vascular system". Zhong Yi Za Zhi 2007: 48: 5-8. |
| [10] | Wang YJ, Zhang MO. Intermingled phlegm and blood stasis and intrarenal micro-accumulation. Zhong Guo Zhong Xi Yi Jie He Za Zhi 2003; 4: 1-3. |
| [11] |
Brenner BM, Meyer TW, Hostetter TH. Dietary protein intake and the progressive nature of kidney disease: the role of hemodynamically mediated glomerular injury in the pathogenesis of progressive glomerular sclerosis in aging, renal ablation, and intrinsic renal disease. N Engl J Med 1982; 307: 652-9.
DOI URL |
| [12] |
Harris RC, Neilson EG. Toward a unified theory of renal progression. Annu Rev Med 2006; 57: 365-80.
PMID |
| [13] |
Ravera M, Re M, Deferrari L, Vettoretti S, Deferrari G. Importance of blood pressure control in chronic kidney disease. J Am Soc Nephrol 2006; 17: S98-103.
DOI PMID |
| [14] | Topaloğlu R. Progression to renal failure. Turk J Pediatr 2005; 47 Suppl: 3-8. |
| [15] |
Hugo C, Kang DH, Johnson RJ. Sustained expression of thrombospondin-1 is associated with the development of glomerular and tubulointerstitial fibrosis in the remnant kidney model. Nephron 2002; 90: 460-70.
PMID |
| [16] |
Johnson RJ. Have we ignored the role of oncotic pressure in the pathogenesis of glomerulosclerosis? Am J Kidney Dis 1997; 29: 147-52.
PMID |
| [17] | Chen XM. The role of coagulation-fibrinolysis system and extracellular matrix regulation system in renal diseases. Zhong Hua Shen Zang Bing Za Zhi 2001: 17: 348-9. |
| [18] |
Sun YB, Qu X, Caruana G, Li J. The origin of renal fibroblasts/myofibroblasts and the signals that trigger fibrosis. Differentiation 2016; 92: 102-7.
DOI PMID |
| [19] |
Piera-Velazquez S, Li Z, Jimenez SA. Role of endothelial-mesenchymal transition (EndoMT) in the pathogenesis of fibrotic disorders. Am J Pathol 2011; 179: 1074-80.
DOI PMID |
| [20] |
Liu Y. Cellular and molecular mechanisms of renal fibrosis. Nat Rev Nephrol 2011; 7: 684-96.
DOI PMID |
| [21] |
Kramann R, DiRocco DP, Humphreys BD. Understanding the origin, activation and regulation of matrix-producing myofibroblasts for treatment of fibrotic disease. J Pathol 2013; 231: 273-89.
DOI URL |
| [22] |
Wang W, Tzanidis A, Divjak M, Thomson NM, Stein-Oakley AN. Altered signaling and regulatory mechanisms of apoptosis in focal and segmental glomerulosclerosis. J Am Soc Nephrol 2001; 12: 1422-33.
DOI PMID |
| [23] |
Mason RM, Wahab NA. Extracellular matrix metabolism in diabetic nephropathy. J Am Soc Nephrol 2003; 14: 1358-73.
DOI PMID |
| [24] |
Haneda M, Koya D, Isono M, Kikkawa R. Overview of glucose signaling in mesangial cells in diabetic nephropathy. J Am Soc Nephrol 2003; 14: 1374-82.
PMID |
| [25] |
Favreau F, Thuillier R, Cau J, et al. Anti-thrombin therapy during warm ischemia and cold preservation prevents chronic kidney graft fibrosis in a DCD model. Am J Transplant 2010; 10: 30-9.
DOI PMID |
| [26] |
Chade AR, Mushin OP, Zhu X, et al. Pathways of renal fibrosis and modulation of matrix turnover in experimental hypercholesterolemia. Hypertension 2005; 46: 772-9.
DOI PMID |
| [27] | LV RH. Diagnosis and treatment of diabetes and its complications by Traditional Chinese and Western Medicine. Beijing: People's Health Publishing House, 1997: 328-37. |
| [28] | Liu SJ, Wang H, Wang YX, Li YY, Lü RH. A preliminary study on the theory of "kidney-collateral micro-accumulation". Zhong Guo Zhong Yi Ji Chu Yi Xue Za Zhi 2009; 15: 649-50. |
| [29] | Higgins JPT TJ, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane handbook for systematic reviews of interventions version 6.2 (updated February 2021): Cochrane; 2021. Available from URL: https://training.cochrane.org/handbook/current. |
| [30] |
Sahebkar A. Head-to-head comparison of fibrates versus statins for elevation of circulating adiponectin concentrations: a systematic review and Meta-analysis. Metabolism 2013; 62: 1876-85.
DOI URL |
| [31] | Liu JY, Yang F, Fan FY, Clinical observation on the treatment of 30 cases of chronic nephritis with tonifying Qi, activating blood and removing blood stasis. Zhong Yi Yao Dao Bao 2007; 13: 20-2. |
| [32] | Huang DH, He HT, Tan YC. Effect of Shenluotong decoction on TGF-β1, MMP-9 and TMP-1 in chronic glumerulonephritis. Zhong Guo Shi Yan Fang Ji Xue Za Zhi 2017; 23: 196-201. |
| [33] | Jin YM, Yin M, Deng YY, et al. Clinical study of treating blood stasis of kidney fibrosis with Dahuang Zhechong Wan. Zhong Guo Zhong Xi Yi Jie He Shen Bing Za Zhi 2009: 10: 788-90. |
| [34] | Hu XM, Xu CX, Qiao CP, Wang CX, Zhang CM. Clinical study on the effect of Bushen Huoxue granule on serum PC-Ⅲ, Col-Ⅳ, LN, FN and renal function in patients with chronic renal insufficiency. Guangxi Zhong Yi Yao 2021; 44: 1-4. |
| [35] | Gao Z, Ku BQ, Qin YF, Liu JG. Effect of Paidu mixture on fibrosis parameters and renal function of patients with chronic renal failure. Xin Zhong Yi 2007: 39: 90-2+8. |
| [36] | Wang XX. Clinnical observation on Chinese medical herbs Yi-shen-pai-zhuo decoction combining benazapril in treating diabetic nephropathy. Zhengzhou: Zhengzhou University, 2009: 2-3. |
| [37] | Zhong HL, Li DG, Jiang L, Ou WN, Yang CP, Zhang YQ. Clinical observation on therapautic effect of Bushen Huoxue Paidu decoction in retarding the course of chronic renal failure. Zhong Guo Zhong Yi Yao Xing Xi Za Zhi 2009; 16: 17-8. |
| [38] | Zhang YM. Therapeutic effect of Fuzheng Huazhuo Tongluo recipe on chronic renal failure and its effect on renal function and oxidative stress. Yunnan Zhong Yi Zhong Yao Za Zhi 2019; 40: 25-7. |
| [39] | Zhang YQ, Wang DH, Zhou JF, Guo LP, Yuan FH. Clinical study of Yanshen capsule on renal protection in patients with chronic nephritis. Zhong Guo Zhong Xi Yi Jie He Shen Bing Za Zhi 2006: 7: 413-5. |
| [40] | Ren QH. Clinical and experimental investigation of Shen-kangling on treating chronic renal failure. Jinan: Shandong University of Traditional Chinese Medicine, 2006: 12-6. |
| [41] | Zhang Z. Clinical and experimental investigation of Shen-kangpian in treating chronic glomerulonephritis. Jinan: Shandong University of Traditional Chinese Medicine, 2005; 2-9. |
| [42] | Chen BM, Liu YF, Liu HY, et al. Clinical observation on Paidu Baoshen pill in the treatment of chronic kidney disease stage two patients. Zhong Guo Zhong Yi Yao Xian Dai Yuan Cheng Jiao Yu 2020; 18: 53-5. |
| [43] | Gao L. Clinical effect and influence on the serum level of type Ⅳ collagen for Zishen Huoxue decoction on chronic renal failure. Nanning: Guangxi University of Traditional Chinese Medicine, 2012: 2-9. |
| [44] | Han HY, Lu JR, Wang XH, Ye JH. Clinical study on renal function and renal fibrosis in patients with chronic kidney disease in 3 and 4 phase by “Ye's renal failure Party A”. Shanghai Zhong Yi Yao Za Zhi 2016; 50: 52-5. |
| [45] | Hu XM. Clinical studies of ‘Zishenhuoxue recipe corpuscles’ effects on TNF-α in the treatmentof anti-renalfibrosis. Nanning: Guangxi University of Traditional Chinese Medicine, 2005: 9-31. |
| [46] | Li J, Li YH. Observation on the therapeutic effect of modified Buyanghuanwu decoction on chronic renal failure. Xian Dai Zhong Xi Yi Jie He Za Zhi 2015; 24: 3568-9+648. |
| [47] | Li KK, Zhang Y, Ma HJ, Cao SL. Optimization study of Huoxue Tongluo treating fibrosis of CKD in early stage. Liaoning Zhong Yi Za Zhi 2015; 42: 916-8. |
| [48] | Ren F, Zhou JJ. Huoshen Tongluo recipe in reducing glomerular fibrosis factor in patients with chronic kidney disease. Jilin Zhong Yi Yao 2013; 33: 1022-4. |
| [49] | Wang Y, He LQ, Zheng DP. Effect of Resisting-fibrosis agent on renal fibrosis and renal function of patients in chronic renal failure. Zhong Guo Zhong Xi Yi Jie He Shen Bing Za Zhi 2002; 3: 396-8. |
| [50] | Xiang SW, Huang GD, Lai SC. Clinical study on Shenankang granule in treating chronic renal failure. Guangzhou Zhong Yi Yao Da Xue Xue Bao 2006: 23: 295-8. |
| [51] | Zhong D. Effect and mechanism of Yiqi Huoxue in the defence and treatment of glomerular sclerosis. Guangzhou: Guangzhou University of Traditional Chinese Medicine, 2006: 3-11. |
| [52] | Zhong D, Zhang YF, Huang YQ, Wang J. Protective effect of Huangqi Danshen mixture on patients with chronic renal insufficiency. Changchun Zhong Yi Yao Da Xue Xue Xue Bao 2012; 28: 406-7. |
| [53] | Zhang CM, Zhou JJ, He LQ, et al. Effect of Kangxianling formula on CKD3-4 and its mechanism: a randomized, controlled, multi-center clinical trial. Liaoning Zhong Yi Za Zhi 2013; 40: 122-4. |
| [54] | Ye RG, Chen YS, Fang JA. Summary of the special discussion on diagnosis, treatment and efficacy criteria of kidney disease. Zhong Guo Zhong Xi Yi Jie He Shen Bing Za Zhi 2003: 249-51. |
| [55] |
Amann B, Tinzmann R, Angelkort B. ACE inhibitors improve diabetic nephropathy through suppression of renal MCP-1. Diabetes Care 2003; 26: 2421-5.
PMID |
| [56] |
Houlihan CA, Akdeniz A, Tsalamandris C, Cooper ME, Jerums G, Gilbert RE. Urinary transforming growth factor-beta excretion in patients with hypertension, type 2 diabetes, and elevated albumin excretion rate: effects of angiotensin receptor blockade and sodium restriction. Diabetes Care 2002; 25: 1072-7.
DOI PMID |
| [57] |
Ravindran S, Munusamy S. Renoprotective mechanisms of sodium-glucose co-transporter 2 (SGLT2) inhibitors against the progression of diabetic kidney disease. J Cell Physiol 2021; 237: 1182-205.
DOI PMID |
| [58] |
Razzaque MS, Taguchi T. Cellular and molecular events leading to renal tubulointerstitial fibrosis. Med Electron Microsc 2002; 35: 68-80.
DOI URL |
| [59] |
Bülow RD, Boor P. Extracellular matrix in kidney fibrosis: more than just a scaffold. J Histochem Cytochem 2019; 67: 643-61.
DOI PMID |
| [60] |
Okuda S, Languino LR, Ruoslahti E, Border WA. Elevated expression of transforming growth factor-beta and proteoglycan production in experimental glomerulonephritis. Possible role in expansion of the mesangial extracellular matrix. J Clin Invest 1990; 86: 453-62.
PMID |
| [61] |
Boor P, Ostendorf T, Floege J. Renal fibrosis: novel insights into mechanisms and therapeutic targets. Nat Rev Nephrol 2010; 6: 643-56.
DOI PMID |
| [62] |
Tomooka S, Border WA, Marshall BC, Noble NA. Glomerular matrix accumulation is linked to inhibition of the plasmin protease system. Kidney Int 1992; 42: 1462-9.
PMID |
| [63] |
Meng XM, Nikolic-Paterson DJ, Lan HY. TGF-β: the master regulator of fibrosis. Nat Rev Nephrol 2016; 12: 325-38.
DOI |
| [64] |
Stewart AG, Thomas B, Koff J. TGF-β: master regulator of inflammation and fibrosis. Respirology 2018; 23: 1096-7.
DOI PMID |
| [65] | Xie P, Cui L, Shan Y, Kang WY. Antithrombotic effect and mechanism of Radix Paeoniae Rubra. Biomed Res Int 2017; 2017: 9475074. |
| [66] | Jin Y, Xie Z, Li S, et al. Combined lipidomics and network pharmacology study of protective effects of Salvia miltiorrhiza against blood stasis syndrome. Evid Based Complement Alternat Med 2021; 2021: 5526778. |
| [67] | Yang L, Wang M, Zhou Y, Yang J, Ye C, Wang C. Shen Shuai Ⅱ recipe attenuates renal interstitial fibrosis by improving hypoxia via the IL-1β/c-Myc pathway. Evid Based Complement Alternat Med 2021; 2021: 5539584. |
| [68] |
Qin T, Wu Y, Liu T, Wu L. Effect of Shenkang on renal fibrosis and activation of renal interstitial fibroblasts through the JAK2/STAT3 pathway. BMC Complement Med Ther 2021; 21: 12.
DOI PMID |
| [69] |
Abdualkader AM, Ghawi AM, Alaama M, Awang M, Merzouk A. Leech therapeutic applications. Indian J Pharm Sci 2013; 75: 127-37.
PMID |
| [70] |
Chen JH, Sun W, Zhou D, Gao K, He WM, Liu L. Effects of Dahuang Zhechong pill on expressions of tissue inhibitor of metalloproteinase-1 and plasminogen activator inhibitor-1 in rats with glomerulosclerosis. Zhong Xi Yi Jie He Xue Bao 2008; 6: 512-6.
DOI URL |
| [71] |
Xu L, Li X, Zhang E, et al. The effect of leech extracts on endothelial cell coagulation-related factors and endothelial dysfuction-related molecules. Clin Exp Hypertens 2019; 41: 220-30.
DOI URL |
| [72] |
Meng L, Qu L, Tang J, Cai SQ, Wang H, Li X. A combination of Chinese herbs, Astragalus membranaceus var. mongholicus and Angelica sinensis, enhanced nitric oxide production in obstructed rat kidney. Vascul Pharmacol 2007; 47: 174-83.
DOI URL |
| [73] |
Wei FN, Chen ZL, Yang HF, et al. Effect of Sanqi oral liquid on the expressions of CD4+, CD8+ and CD68+ cells in 5/6 nephrectomized rats with chronic renal failure. Chin J Integr Med 2013; 19: 589-95.
DOI URL |
| [74] | Yang F, Li Y, Guo S, Pan Y, Yan C, Chen Z. Hirudo lyophilized powder ameliorates renal injury in diabetic rats by suppressing oxidative stress and inflammation. Evid Based Complement Alternat Med 2021; 2021: 6657673. |
| [75] | Xia CH, Han XT, Zhang X, et al. Yiqihuoxue formula activates autophagy and offers renoprotection in a rat model of adenine-induced kidney disease. Evid Based Complement Alternat Med 2019; 2019: 3423981. |
| [76] |
Jia Q, Han L, Zhang X, et al. Tongluo Yishen decoction ameliorates renal fibrosis via regulating mitochondrial dysfunction induced by oxidative stress in unilateral ureteral obstruction rats. Front Pharmacol 2021; 12: 762756.
DOI URL |
| [77] |
Zhang LY, Jin J, Luo K, et al. Shen-Kang protects against tacrolimus-induced renal injury. Korean J Intern Med 2019; 34: 1078-90.
DOI PMID |
| [78] |
Cao L, Huang B, Fu X, Yang J, Lin Y, Lin F. Effects of tanshinone IIA on the regulation of renal proximal tubular fibrosis. Mol Med Rep 2017; 15: 4247-52.
DOI PMID |
| [79] |
Zhou S, Ai Z, Li W, et al. Deciphering the pharmacological mechanisms of Taohe-Chengqi decoction extract against renal fibrosis through integrating network pharmacology and experimental validation in vitro and in vivo. Front Pharmacol 2020; 11: 425.
DOI URL |
| [80] | Liu Y, Shi G, Yee H, et al. Shenkang injection, a modern preparation of Chinese patent medicine, diminishes tubulointerstitial fibrosis in obstructive nephropathy via targeting pericyte-myofibroblast transition. Am J Transl Res 2019; 11: 1980-96. |
| [1] | QIN Xiaoyu, WANG Chunai, XUE Jianjun, ZHANG Jie, LU Xiaoting, DING Shengshuang, GE Long, WANG Minzhen. Efficacy of electroacupuncture on myocardial protection and postoperative rehabilitation in patients undergoing cardiac surgery with cardiopulmonary bypass: a systematic review and Meta-analysis [J]. Journal of Traditional Chinese Medicine, 2024, 44(1): 1-15. |
| [2] | LIU Tingting, LIU Tongou, LIU Mingfu. Effectiveness and safety of acupuncture in treatment of pregnancy-related symptoms: a systematic review and Meta-analysis [J]. Journal of Traditional Chinese Medicine, 2024, 44(1): 16-26. |
| [3] | WANG Jiabao, ZHANG Lishuang, NIU Baihan, YU Yajun, YANG Fengwen, MIAO Lin, CHAI Lijuan, DING Xinya, SUN Yingjie, WANG Yujing, WANG Lin, ZHANG Han, WANG Yi, LI Lin. Efficacy and safety of Weichang’ an pill (胃肠安丸) combined with Western Medicine on gastrointestinal diseases: a systematic review and Meta-analysis [J]. Journal of Traditional Chinese Medicine, 2023, 43(6): 1057-1067. |
| [4] | FAN Rong, HE Haoyu, TANG Tao, CUI Hanjin. Long-term effects of Qingfei Paidu decoction (清肺排毒汤) in patients with coronavirus disease 2019 acute pneumonia after treatment: a protocol for systematic review and Meta-analysis [J]. Journal of Traditional Chinese Medicine, 2023, 43(6): 1068-1071. |
| [5] | ZHANG Meizhen, HAO Xiaohui, TANG Yiting, CHEN Yupeng, HE Puyu, ZHAO Liming, PANG Bing, NI Qing. Efficacy and safety of Buyang Huanwu decoction (补阳还五汤) for diabetic peripheral neuropathy: a systematic review and Meta-analysis [J]. Journal of Traditional Chinese Medicine, 2023, 43(5): 841-850. |
| [6] | YANG Yuqing, CHEN Yuhuan, LI Chunxiao, LING Xiao, WANG Panpan, GUO Jing, ZHANG Yingying. Effectiveness and safety of Pingxiao capsule (平消胶囊) as adjuvant therapy in treatment of breast cancer: a systematic review and Meta-analysis [J]. Journal of Traditional Chinese Medicine, 2023, 43(5): 851-859. |
| [7] | ZHAO HuiYan, JUN Purumea, LEE Chaewon, HAN Chang-Hyun. Acupoint catgut embedding for simple obesity in animal studies: a systematic review and Meta-analysis [J]. Journal of Traditional Chinese Medicine, 2023, 43(5): 860-867. |
| [8] | SUN Wu, ZHAO Yuwei, LIAO Liang, ZHAO Zhonghui, CHEN Shiqi, YAN Xiaoling, WANG Xueyao, CHAO Guojun, ZHOU Jian. Effectiveness and safety of Xuebijing injection for patients with coronavirus disease 2019: a systematic review and Meta-analysis [J]. Journal of Traditional Chinese Medicine, 2023, 43(4): 631-639. |
| [9] | WANG Chao, WU Qiong, LI Ping, WANG Zhigang, LOU Xusheng, LI Yuanyuan, ZHANG Lin. Effect of Traditional Chinese Medicine combined with Western Medicine on blood lipid levels and inflammatory factors in patients with angina pectoris in coronary heart disease identified as intermingled phlegm and blood stasis syndrome: a network Meta-analysis [J]. Journal of Traditional Chinese Medicine, 2023, 43(4): 640-649. |
| [10] | MENG Xiangran, CAO Xue, SUN Minglin, AI Yanke, HE Liyun, LIU Jia. Effectiveness and safety of Angong Niuhuang pill (安宫牛黄丸) in treatment of acute stroke: a systematic review and Meta-analysis [J]. Journal of Traditional Chinese Medicine, 2023, 43(4): 650-660. |
| [11] | ZHAO Ye, WANG Xian, GU Ling, LI Zihang, ZHU Jingtian, WANG Wenkai, ZHANG Liang, XUE Mei. Efficacy of Danggui Buxue decoction (当归补血汤) on diabetic nephropathy-induced renal fibrosis in rats and possible mechanism [J]. Journal of Traditional Chinese Medicine, 2023, 43(3): 507-513. |
| [12] | ZHANG Yuehong, SHAO Xianzhi, ZHAO Qianlong, ZHAN Hualong, ZHANG Jianhua, DU Sisi, CHEN Jing, LIU Yingfang, ZHOU Haiwang, CHEN Xinsheng, HONG Ying, LIAN Fengmei, TONG Xiaolin, BA Yuanming. Effectiveness of Xiangsha Liujun pills (香砂六君丸) on decreased digestive function in convalescent patients of coronavirus disease 2019: a randomized, double blind, placebo controlled clinical trial [J]. Journal of Traditional Chinese Medicine, 2023, 43(3): 552-558. |
| [13] | HE Jiakai, ZHANG Jinling, WANG Yu, LI Shaoyuan, FANG Jiliang, ZHANG Shuai, ZHAO Yanan, ZHAI Weihang, GAO Deqiang, LI Ran, JIANG Yuhang, CHEN Zehao, JIA Baohui, RONG Peijing. Transcutaneous auricular vagus nerve stimulation would be an alternative to implantable cervical vagus nerve stimulation in some situation [J]. Journal of Traditional Chinese Medicine, 2023, 43(3): 627-630. |
| [14] | GUO Wen, LI Xuanlin, ZHAO Hulei, LEI Siyuan, XIE Yang, LI Jiansheng. Effectiveness of Chinese herbal medicine combined with conventional medicine on acute exacerbation of chronic obstructive pulmonary disease: a systematic review and Meta-analysis [J]. Journal of Traditional Chinese Medicine, 2023, 43(2): 212-220. |
| [15] | ZHANG Junli, HE Ying, ZHANG Xia, FU Hongfang, HU Xiaoyu. Fuzheng Huayu preparation (扶正化瘀胶囊/片) combined with tenofovir disoproxil fumarate on hepatitis B: a systematic review and Meta-analysis [J]. Journal of Traditional Chinese Medicine, 2023, 43(2): 221-230. |
| Viewed | ||||||
|
Full text |
|
|||||
|
Abstract |
|
|||||
