Panax notoginseng preparations as adjuvant therapy for diabetic kidney disease: a systematic review and meta-analysis

Abstract

Context: Panax notoginseng (Burk.) F.H. Chen (Araliaceae) preparations (PNP) are traditional Chinese medicines used as adjuvant therapeutics for diabetic kidney disease (DKD). Objective: To systematically review the efficacy of PNP as adjunct DKD therapy, including their effects on kidney function, serum lipid levels and fasting blood glucose levels. Methods: The databases PubMed, Embase, Medline, Cochrane Library, CINAHL, China Biology Medicine disc, Wanfang, VIP and China National Knowledge Infrastructure were systematically searched from the date of their inception until May 2019. Panax notoginseng, Panax notoginseng saponins, Lulutong, Xueshuantong and Xuesaitong were the key terms searched. Randomized controlled trials (RCTs) comparing the combined use of PNP and conventional medicines (CM) versus CM for DKD were included. Data were pooled using random or fixed effect models depending on heterogeneity. Results: In total, 24 RCTs involving 1918 participants were analysed. Adjunct PNP with CM was associated with reduction of albuminuria (MD-26.89 mg, 95% CI:-33.35 to-20.42), proteinuria (MD-0.32 g/24 h, 95% CI:-0.36 to-0.27), serum creatinine (MD-4.52 lmol/L, 95% CI:-8.71 to-0.32), total cholesterol (MD-1.56 mmol/L, 95% CI:-2.33 to-0.78), triglycerides (TG) (MD-0.56 mmol/L, 95% CI:-0.80 to-0.31) and low-density lipoprotein cholesterol (MD-0.94 mmol/L, 95% CI:-1.49 to-0.40) compared with CM. Conclusions: This is the first meta-analysis investigating adjuvant PNP therapy for DKD. PNP apparently exerted beneficial effects on kidney function and improved the metabolism of serum lipids by CM. Further, well-conducted, high-quality trials on DKD patients are needed to provide high-quality evidence.

A Comparative Analysis on the Structure and Function of the Panax notoginseng Rhizosphere Microbiome

“…It belongs to the family Araliaceae ( Guo et al, 2010 ). There is a very high global demand for this species due to its antihypertensive, antithrombotic, anti-atherosclerotic, anti-tumor, anti-oxidant, and hepatoprotective activities ( Zhou et al, 2009 ; Yang et al, 2015 ; Dong et al, 2019 ; Li et al, 2019 ; Liu et al, 2019 ; Zhang et al, 2019a ; Tang et al, 2020 ). Recently, more than 4 million hectares of land are cultivated annually in China for this species ( Shoyama et al, 1997 ; Deborah et al, 2005 ; Wei et al, 2015 ).…”

Network Pharmacology Combined with Bioinformatics to Investigate the Mechanisms and Molecular Targets of Astragalus Radix-Panax notoginseng Herb Pair on Treating Diabetic Nephropathy

“…Nevertheless, effective treatments remain scarce. Previous studies have been demonstrated that AR and PN play a critical role in treating DN [ 12 – 14 , 50 ], suggesting AR-PN may be a potential herb pair for the treatment of DN. For all we know, this is the first study to perform a comprehensive analysis of network pharmacology combined with gene expression profiling to further explore the underlying pharmacological mechanisms and therapeutic targets of the AR-PN herb pair on DN.…”

“…Likewise, it has been confirmed that AR possesses antioxidative stress effects [ 13 ]. Previous research demonstrated that PN can significantly reduce albuminuria, proteinuria, and serum creatinine and improve the metabolism of serum lipids in patients with DN [ 14 ]. In addition, both in vivo and in vitro research studies confirmed that the combination of AR and PN could strengthen the renoprotection effects by inhibiting inflammation, alleviating oxidative stress, and upregulating autophagy [ 15 ].…”

Mechanisms and Efficacy of Chinese Herbal Medicines in Chronic Kidney Disease

“…Another systematic review and meta-analysis review included 24 RCTs to assess efficacy and safety of Panax notoginseng (Burkill) F.H.Chen in diabetic nephropathy ( Tang et al, 2020 ). Compared with conventional medicines, Panax notoginseng (Burkill) F.H.Chen combined with conventional medicines was associated with reductions of albuminuria, proteinuria, and levels of SCr, total cholesterol, triglycerides, and low-density lipoprotein cholesterol.…”