Meta-analysis-based systematic review of effect of traditional Chinese medicine intervention in treatment of diabetic nephropathy on thyroid function.

Background: This research sought to systematically evaluate the clinical effects of traditional Chinese medicine (TCM) intervention in the treatment of diabetic nephropathy (DN) and analyze changes in thyroid function in patients with DN.

Methods: The PubMed, Embase, Medline, Ovid, Springer, and self-built databases were searched to screen literature on TCM intervention and the treatment of DN published from the establishment of the databases to January 1, 2021. The Cochrane Handbook for Systematic Reviews of Intervention 5.0.2 was then employed to assess the risk of bias in literature, and Review Manager 5.3 was utilized for the meta-analysis.

Results: A total of 20 randomized controlled trials (RCTs) were included in the study, involving 3,566 subjects, and meta-analysis results showed that the clinical treatment efficiency of the experimental group was dramatically higher than the control group [MD =6.22, 95% confidence interval (CI): 3.77-10.25, Z=7.17, P<0.00001]. Moreover, the serum creatinine (Scr), blood urea nitrogen (BUN), urine protein excretion rate (UAER), 24 h postoperative urine protein quantification, and tumor necrosis factor-alpha (TNF-α) of patients after TCM intervention were all remarkably inferior to those of the control group as seen in the following results: Scr, MD =-8.69, 95% CI: -9.92 to -7.47, Z=13.94, P<0.00001; BUN, MD =-1.74, 95% CI: - 2.48 to -1.00, Z=4.6, P<0.00001; UAER, MD =-26.16, 95% CI: -46.89 to -5.44, Z=2.47, P=0.01; 24 h postoperative urine protein quantification, MD =-0.54, 95% CI: -0.68 to -0.4, Z=7.4, P<0.00001; TNF-α, MD =-5.3, 95% CI: -9.15 to -1.46, Z=2.7, P=0.007; and high sensitivity C-reactive protein (hs-CRP), MD =-1.34, 95% CI: -1.9 to -0.78, Z=4.66, P<0.00001.

Discussion: TCM intervention in DN is effective in treating the clinical symptoms of patients with this disease and has ideal therapeutic effects.