Fufang Xueshuantong for Diabetic Kidney Disease: A Systematic Review and Meta-Analysis

Abstract

Objective. The objective of this meta-analysis was to systematically assess the efficacy and safety of patented Chinese medicine Fufang Xueshuantong (FFXST) for the treatment of diabetic kidney disease (DKD). Methods. Randomized controlled trials (RCTs) of FFXST for DKD treatment were searched until May 31, 2020, in seven electronic databases: PubMed, Embase, Cochrane Library, CNKI, Wanfang, VIP, and Chinese Biomedical Literature. The Cochrane risk test from the Cochrane Handbook was used as a bias tool to assess the methodological quality, and Review Manager (RevMan) 5.3 was used to analyze the results. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria were used to classify the quality of evidence. Results. Thirteen RCTs involving 1,186 patients were included. The meta-analysis revealed that the efficacy of FFXST in treatment of DKD was significantly superior to that of the control treatment ( $P=\text{0.}0006$ ). The urinary albumin excretion rate ( $P<0.01$ ), urinary albumin creatinine ratio ( $P<0.0001$ ), and microalbumin ( $P<0.0001$ ) were lower in the treatment groups than in the control group. There was also a decrease in low-density lipoprotein cholesterol ( $P<0.0001$ ), serum triglyceride ( $P=0.001$ ), and C-reactive protein ( $P<0.0001$ ) in the treatment groups compared with those in the control group. No significant difference in hemoglobin A1c level ( $P=0.76$ ) and systolic blood pressure ( $P=0.34$ ) was noted between the treatment and control groups. Three studies reported adverse events, including dizziness and intolerance. In the other 10 trials, adverse events were not mentioned. Conclusion. FFXST appears to be effective in the treatment of DKD. However, the low methodological quality of the RCTs suggests that larger, better-designed RCTs are required to verify the clinical effectiveness and safety of FFXST.