DOI QR코드

DOI QR Code

Adjuvant Therapy Efficacy of Herbal Medicine Zeo Lyung Tang (Zhu Ling Decoction) for Primary Glomerulonephritis: Systematic Review and Meta-Analysis

일차성 사구체신염에 대한 저령탕 병용요법의 효능 : 체계적 문헌고찰 및 메타 분석

  • Received : 2020.08.25
  • Accepted : 2020.09.28
  • Published : 2020.09.30

Abstract

Objectives: The aim of this study was to systematically evaluate the clinical therapeutic effects and safety of the Zeo lyung tang (ZLT) on primary glomerulonephritis (PGN). Methods: The MEDLINE, EMBASE, PubMed, CENTRAL, CNKI, RISS, NDSL, KISS, and OASIS databases were searched for randomized controlled trials (RCTs) testing the effects of ZLT on PGN. The Cochrane collaboration bias risk assessment scale was used to evaluate the methodological quality of the included studies. RevMan 5.3 software was used for data analysis. Results: Ten RCTs involving 781 patients were included in the review. Compared with conventional Western medicine (WM) therapy alone, a combination treatment of ZLT and WM improved the total effective rate (RR=1.24; 95%CI [1.16, 1.33]; p<0.00001), reduce the blood urea nitrogen (BUN; MD=-1.05; 95%CI [-1.32, -0.78]; p<0.00001) and the 24-hour urinary protein (MD=-0.38; 95%CI [-0.46, -0.29]; p<0.00001). Conclusions: The combination of ZLT with WM has therapeutic effects on PGN, and it has advantages over WM treatment alone in reducing BUN and 24-hour urinary protein. However, due to the low quality of the included studies and the small sample sizes, additional research is needed in this area.

Keywords

References

  1. Sethi S, Fervenza FC. Standardized classification and reporting of glomerulonephritis. Nephrol Dial Transplant 2019;34(2):193-9. https://doi.org/10.1093/ndt/gfy220
  2. McGrogan A, Franssen CF, de Vries CS. The incidence of primary glomerulonephritis worldwide: a systematic review of the literature. Nephrol Dial Transplant 2011;26(2):414-30. https://doi.org/10.1093/ndt/gfq665
  3. Floege J, Amann K. Primary glomerulonephritides. Lancet 2016;387(10032):2036-48. https://doi.org/10.1016/S0140-6736(16)00272-5
  4. Chou YH, Lien YC, Hu FC, Lin WC, Kao CC, Lai CF, et al. Clinical outcomes and predictors for ESRD and mortality in primary GN. Clin J Am Soc Nephrol 2012;7(9):1401-8. https://doi.org/10.2215/CJN.04500511
  5. Sethi S, Haas M, Markowitz GS, D'Agati VD, Rennke HG, Jennette JC, et al. Mayo Clinic/Renal Pathology Society Consensus Report on Pathologic Classification, Diagnosis, and Reporting of GN. J Am Soc Nephrol 2016;27(5):1278-87. https://doi.org/10.1681/ASN.2015060612
  6. Radhakrishnan J, Cattran DC. The KDIGO practice guideline on glomerulonephritis: reading between the (guide)lines--application to the individual patient. Kidney Int 2012;82(8):840-56. https://doi.org/10.1038/ki.2012.280
  7. Jiang S, Chuang PY, Liu ZH, He JC. The primary glomerulonephritides: a systems biology approach. Nat Rev Nephrol 2013;9(9):500-12. https://doi.org/10.1038/nrneph.2013.129
  8. Wang YJ, He LQ, Sun W, Lu Y, Wang XQ, Zhang PQ, et al. Optimized project of traditional Chinese medicine in treating chronic kidney disease stage 3: a multicenter double-blinded randomized controlled trial. J Ethnopharmacol 2012;139(3):757-64. https://doi.org/10.1016/j.jep.2011.12.009
  9. Huang KC, Su YC, Sun MF, Huang ST. Chinese Herbal Medicine Improves the Long-Term Survival Rate of Patients With Chronic Kidney Disease in Taiwan: A Nationwide Retrospective Population-Based Cohort Study. Front Pharmacol 2018;9:1117. Published 2018 Oct 1. https://doi.org/10.3389/fphar.2018.01117
  10. Zhong Y, Menon MC, Deng Y, Chen Y, He JC. Recent Advances in Traditional Chinese Medicine for Kidney Disease. Am J Kidney Dis 2015;66(3):513-22. https://doi.org/10.1053/j.ajkd.2015.04.013
  11. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions (Version 5.1.0). The Cochrane Collaboration 2011.
  12. Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 2009;151(4):264. https://doi.org/10.7326/0003-4819-151-4-200908180-00135
  13. The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Copenhagen, Denmark: The Nordic Cochrane Centre, The Cochrane Collaboration 2014.
  14. Higgins JPT, Altman DG, Gotzsche PC, Juni P, Moher D, Oxman AD, et al. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ 2011;343:d5928. Published 2011 Oct 18. https://doi.org/10.1136/bmj.d5928
  15. Cen WX. Clinical Observation on Treatment of 43 Cases of Chronic Glomerulonephritis with Liuwei Dihuang Decoction and Zhuling Decoction. Hunan Journal of Traditional Chinese Medicine 2013;29(11):43-4.
  16. Chen J, Wang T. Study on the Effect of Compound Zhuling Decoction in the Treatment of Chronic Glomerulonephritis. Journal of China Prescription Drug 2018;16(10):103-4.
  17. Guan XD, Huang ZH. Analysis of the therapeutic effect of Compound Zhuling Decoction on chronic glomerulonephritis. Chinese Medicine Modern Distance Education of China 2017;15(5):94-5.
  18. Ma WZ, Wang L, Deng M, Ding XM. Effect of Compound Zhuling Decoction on Urinary Protein Level and Complications in Patients with Chronic Glomerulonephritis. J Med Theor & Prac 2020;33(6):925-7.
  19. Quan SJ, Lian ML, Xiong MQ, Chen RC. Clinical Study on the Effect of Jiawei Zhuling Decoction on Membranoproliferative Glomerulonephritis. Journal of Traditional Chinese Medicine 2001;42(5):282-4. https://doi.org/10.3321/j.issn:1001-1668.2001.05.019
  20. Su XH. Observation on Curative Effect of Modified Zhuling Decoction in Treating 30 Cases of Chronic Glomerulonephritis. Chin J of Clinical Rational Drug Use 2010;3(19):58-9.
  21. Xi YP. Effect of Modified Zhuling Decoction on Chronic Glomerulonephritis. Seek Medical And Ask The Medicine 2013;11(10):162-3.
  22. Xu WM. Clinical Observation on Treatment of Chronic Glomerulonephritis with Integrative Chinese-Western Medicine. Asia-Pacific Traditional Medicine 2015;11(2):74-5. https://doi.org/10.11954/ytctyy.201502031
  23. Yang XB. Study on the Effect of Compound Zhuling Decoction in the Treatment of Chronic Glomerulonephritis. China Medical Devices 2017;32(S2):75-6.
  24. Zhu ZJ. Treatment of 57 Cases of Chronic Glomerulonephritis with Zhuling Decoction. Hunan Journal of Traditional Chinese Medicine 2003;19(2):45.
  25. Zhang J, Bian L, Ma FZ, Jia Y, Lin P. Efficacy and safety of rituximab therapy for membranous nephropathy: a meta-analysis. Eur Rev Med Pharmacol Sci 2018;22(22):8021-9.
  26. Cheng J, Zhang W, Zhang XH, He Q, Tao XJ, Chen JH. ACEI/ARB therapy for IgA nephropathy: a meta analysis of randomised controlled trials. Int J Clin Pract 2009;63(6):880-8. https://doi.org/10.1111/j.1742-1241.2009.02038.x
  27. Su K, Guo L. The progression about clinical and experimental study of polypore umbellate decoction application in chronic kidney. China journal of Chinese medicine 2010;25(148):589-92.
  28. Wang Z, Feng D. Research progress on the diagnosis and treatment of Zhuling decoction. Chinese medicine modern distance education of china 2017;15(3):143-5.
  29. Yang B, Xie Y, Guo M, Rosner MH, Yang H, Ronco C. Nephrotoxicity and Chinese Herbal Medicine. Clin J Am Soc Nephrol 2018;13(10):1605-11. https://doi.org/10.2215/CJN.11571017
  30. Hsieh CF, Huang SL, Chen CL, Chen WT, Chang HC, Yang CC. Non-aristolochic acid prescribed Chinese herbal medicines and the risk of mortality in patients with chronic kidney disease: results from a population-based follow-up study. BMJ Open 2014;4(2):e004033. Published 2014 Feb 21. https://doi.org/10.1136/bmjopen-2013-004033