温阳中药治疗糖尿病肾病网状Meta分析OA

Objective To systematically evaluate the clinical efficacy and safety of warm-yang Chinese herbal medicine in treating diabetic kidney disease(DKD)with yang deficiency syndrome.Methods Randomized controlled trials(RCTs)on warm-yang Chinese herb medicine for DKD were retrieved from eight databases.Meta-analysis and network meta-analysis were conducted using RevMan 5.3 and Stata 16.Results Thirty-three studies involving 2 725 DKD patients and nine warm-yang herbal medicines combined with routine treatment(RT)were included.Meta-analysis showed that compared with RT alone,the efficacy of combined warm-yang Chinese herbal medicine was better than that of RT in terms of clinical efficacy rate,Chinese medicine(CM)syndrome score,renal function,blood glucose level.Network Meta-analysis revealed:Shipisan ranked highest for improving overall clinical efficacy rate;Gualou Qumai Tang was optimal for alleviating CM symptoms and reducing fasting and postprandial blood glucose;Shenqiwan was best for reducing serum creatinine,24-hour urinary protein,and glycated hemoglobin;Zhenwu Tang+Lizhong Wan was superior in lowering blood urea nitrogen.Adverse reactions primarily involved gastrointestinal and nervous systems.Conclusions The combination of warm-yang Chinese herbal medicine with RT can improve clinical efficacy rate,alleviate symptoms,and benefit renal function and glycemic control in DKD patients with yang deficiency.This integrated approach provides a reference for clinical practice,further validation through more high-quality studies is warranted.