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Journal of Traditional Chinese Medicine >

2023 , Vol. 43 >Issue 3: 429 - 440

DOI: https://doi.org/10.19852/j.cnki.jtcm.20230308.003

Meta-analysises

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

  • Xin LUO ,
  • Jing XIE ,
  • Li HUANG ,
  • Wenfan GAN ,
  • Ming CHEN
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  • 1 Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610072, China
    2 Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China

Received date: 2021-11-02

  Accepted date: 2022-05-18

  Online published: 2023-03-08

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)

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Abstract

OBJECTIVE: To evaluate the efficacy and safety of activating blood circulation and removing blood stasis in terms of Traditional Chinese Medicine (TCM) for managing renal fibrosis (RF) in patients with chronic kidney disease (CKD).

METHODS: We searched randomized controlled trials (RCTs) from eight databases.

RESULTS: Sixteen eligible studies with 1,356 participants were included in this study. Compared to treatment with Western Medicine (WM) alone, the combined treatment with activating blood circulation and removing blood stasis in terms of TCM (ARTCM) and WM to manage RF in patients with CKD significantly ameliorated type Ⅳ collagen (C-Ⅳ) (SMD: -2.17, 95% CI: 3.01 to -1.34), type Ⅲ procollagen (PC-Ⅲ) (SMD: -1.08, 95% CI: -1.64 to -0.53), laminin (LN) (SMD: -1.28, 95% CI: -1.65 to -0.90), transforming growth factor β 1 (TGF-β1) (SMD: -0.65, 95% CI: -1.18 to -0.12), serum creatinine (Scr) (SMD: -1.36, 95% CI: -1.85 to -0.87), blood urea nitrogen (BUN) (MD: -1.51, 95% CI: -2.59 to -0.43), and 24 h urine protein (24hUpro) (SMD: -1.23; 95% CI: -1.96 to -0.50). The level of hyaluronic acid (HA) was similar in both types of treatment (SMD: -0.74, 95% CI: -1.91 to 0.44). The subgroup analysis showed that the duration of 8 weeks might affect the concentration of C-Ⅳ, PC-Ⅲ, and LN (P<0.05). The effectiveness of the longer duration to C-Ⅳ, PC-Ⅲ, and LN was not certain. However, the result should be interpreted in care. The safety of the treatment using ARTCM and WM could not be evaluated because a few studies had reported adverse effects. The results of the Meta-analysis were not stable enough. There was publication bias for the reports on Scr (P = 0.001), C-Ⅳ (P = 0.001), PC-Ⅲ (P = 0.026), and LN (P = 0.030) and no publication bias for the reports on BUN (P = 0.293). The quality of evidence varied from low to very low.

CONCLUSIONS: The combined treatment using ARTCM and WM to manage RF in patients with CKD has some advantages over treatment with WM alone. High-quality RCTs need to be conducted for the strong support.

Key words： Medicine, Chinese traditional; activating blood circulation and removing blood stasis; renal fibrosis; efficacy; safety; Meta-analysis; systematic review

Cite this article

Xin LUO , Jing XIE , Li HUANG , Wenfan GAN , Ming CHEN . 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 . DOI: 10.19852/j.cnki.jtcm.20230308.003

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