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Therapeutic Effect and Safety of Tripterygium Glycosides Combined With Western Medicine on Type 2 Diabetic Kidney Disease: A Meta-Analysis

  • Author Footnotes
    ⁎ These authors contributed equally to this work.
    Dandan Xie
    Footnotes
    ⁎ These authors contributed equally to this work.
    Affiliations
    College of Traditional Chinese Medicine, Hainan Medical University, Haikou, Hainan, China

    National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, Health Management Center and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China

    Department of Clinical Nutrition, the Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
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  • Author Footnotes
    ⁎ These authors contributed equally to this work.
    Kai Li
    Footnotes
    ⁎ These authors contributed equally to this work.
    Affiliations
    College of Traditional Chinese Medicine, Hainan Medical University, Haikou, Hainan, China
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  • Tianpeng Ma
    Affiliations
    College of Traditional Chinese Medicine, Hainan Medical University, Haikou, Hainan, China
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  • Huan Jiang
    Affiliations
    College of Traditional Chinese Medicine, Hainan Medical University, Haikou, Hainan, China
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  • Fei Wang
    Affiliations
    College of Traditional Chinese Medicine, Hainan Medical University, Haikou, Hainan, China
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  • Mingyue Huang
    Affiliations
    College of Traditional Chinese Medicine, Hainan Medical University, Haikou, Hainan, China
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  • Zhifeng Sheng
    Correspondence
    Address correspondence to: Yiqiang Xie, PhD, College of traditional Chinese medicine, Hainan Medical University, Haikou, Hainan Province, 571199, PR China.
    Affiliations
    National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, Health Management Center and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
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  • Yiqiang Xie
    Correspondence
    Address correspondence to: Yiqiang Xie, PhD, College of traditional Chinese medicine, Hainan Medical University, Haikou, Hainan Province, 571199, PR China.
    Affiliations
    College of Traditional Chinese Medicine, Hainan Medical University, Haikou, Hainan, China
    Search for articles by this author
  • Author Footnotes
    ⁎ These authors contributed equally to this work.

      ABSTRACT

      Purpose

      Tripterygium glycosides (TG) are widely used for the treatment of kidney disease in China. However, the application of TG in clinical practice is limited, as the therapeutic window is narrow, and the therapeutic dose is close to the toxic dose. In addition, the therapeutic effect of TG combined with Western medicine has not been fully elucidated. This study sought to explore standardized treatment, efficacy, and safety of TG combined with Western medicine for patients with type 2 diabetic kidney disease (T2DKD).

      Methods

      The PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure, Chinese Biomedical Literature, Chinese Scientific Journal, and Wan Fang databases were searched for randomized controlled trials of TG combined with Western medicine on T2DKD from their inception until May 4, 2021. A random effects model was used to explore heterogeneity of studies.

      Findings

      A total of 33 studies with 2034 patients were included in the current meta-analysis. The findings showed that TG combined with Western medicine effectively reduced urinary albumin excretion rates (standardized mean difference, –2.55; 95% CI, –4.70 to –0.40; P = 0.02), 24-hour urinary protein level (mean difference, –0.79; 95% CI, –1.22 to –0.36; P = 0.0003), and serum creatinine level (mean difference, –8.23; 95% CI, –14.48 to –1.99; P = 0.01) and increased albumin level (mean difference, 4.70; 95% CI, 3.27 to 6.13; P < 0.00001) in patients with T2DKD. No serious adverse reactions occurred, and the incidence of adverse events in the TG combined with Western medicine treatment group was slightly higher than in the control group (8.14% vs 2.65%). The results were stable, and a significant publication bias was not detected (P > 0.05).

      Implications

      Based on our results, TG combined with Western medicine may be an effective and safe therapy for T2DKD; the best treatment duration may be 3 to 6 months. Nevertheless, larger, longer multicenter studies should be conducted for clinical application of the regimen to patients in more countries and regions. PROSPERO registration number: CRD42021259466.

      Keywords

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