Efficacy of Chinese Herbal Injections for the Treatment of Primary Nephrotic Syndrome: A Bayesian Network Meta-Analysis of Randomized Controlled Trials

Abstract

Background: Considering the adverse reactions and side effects of immunosuppressive and cytotoxic drugs for the treatment of Primary Nephrotic Syndrome (PNS) and the extensive exploration of Chinese herbal injections (CHIs), systematic evaluation of the efficacy of different CHIs in the treatment of PNS is a key imperative. In this study, we performed a network meta-analysis to investigate the efficacy of CHIs in the treatment of PNS. Methods: A systematic literature review including studies published from the establishment of each database to May 28, 2020, was conducted in PubMed, the Cochrane Library, Embase, Web of Science, the Chinese Biological Medicine Literature Service System (CBM), the China National Knowledge Infrastructure (CNKI) database, the Chinese Scientific Journal Database (VIP), and the Wanfang Database (WF).Two evaluators independently screened the literature, extracted data and the Cochrane Reviewer's Handbook 5.1 method was used to evaluate the quality of included studies. The differences in efficacy of different CHIs were compared and ranked using Stata 16.0 software. Surface under the cumulative ranking curve (SUCRA) probability values were applied to rank the examined treatments. Clustering analysis was performed to compare the effects of CHIs between two different outcomes. Results: A total of 41 eligible randomized controlled trials involving 2879 patients and nine CHIs were included. Nine CHIs were Xiangdan injection (XDI), Huangqi injection (HQI), Shenkang injection (SKI), Danshen injection (DSI), Yinxingdamo injection (YXI), Dengzhanhuasu injection (DZI), Danhong injection (DHI), Shuxuetong injection (SXI), Chuanxiongqin injection (CXI). The results of the network meta-analysis showed that: with Western medical (WM) treatment as a co-intervention, in terms of improving the total clinical effectiveness and serum albumin level, DHI was the most likely to be the best choice for treatment (SUCRA = 82.2%); YXI had the highest probability of being the best option in terms of reducing 24-h urinary protein excretion (SUCRA = 97.8%);

Membranous nephropathy: Systems biology-based novel mechanism and traditional Chinese medicine therapy

“…Enrichment analysis indicates that major pathways are advanced glycation end products, interleukin-17, tumor necrosis factor and Toll-like receptor signaling pathways (Shi et al, 2022). In addition, the combination of chemical drugs and Yinxingdamo injection or Danhong injection showed the best Chinese herbal injections compared with total clinical effectiveness, serum albumin and 24-h urinary protein excretion (Yu, H. et al, 2020). These findings demonstrate that traditional Chinese medicines can effectively ameliorate patients with IMN.…”

Recent Advances in Clinical Diagnosis and Pharmacotherapy Options of Membranous Nephropathy

“…In addition, Yu et al (2020 ) reported that Chinese herbal injections were demonstrated to be superior to treatment of chemical drugs alone in the treatment of primary nephrotic syndrome and might be beneficial for patients with primary nephrotic syndrome. The combination of chemical drugs and Yinxingdamo injection and chemical drugs and Danhong injection had the potential to be the best Chinese herbal injections relative to total clinical effectiveness, serum albumin, and 24-h urinary protein excretion.…”

Traditional Chinese Medicine Strategy for Patients with Tourette Syndrome Based on Clinical Efficacy and Safety: A Meta-Analysis of 47 Randomized Controlled Trials

“…As a branch of alternative medicine and ethnopharmacology that dates back to ancient China, traditional Chinese medicine (TCM) has been widely supported by clinical trials for its efficacy and lower rate of recurrence and undesirable side effects [13]. Developed based on traditional and modern medicine theories, TCM, or TCM-assisted treatments, with obvious advantages of high bioavailability and quick effect, is widely used for treating various clinical diseases and, to some extent, effective in relieving the clinical symptoms, such as primary nephrotic syndrome, poststroke depression, or communityacquired pneumonia [14][15][16]. Although several trials have examined the effectiveness of TCM in treating TS, there have been few studies to combine the available evidence of trials to explore the potential relationship between TCM and TS in terms of efficacy and safety.…”