Meta-analysis of Dose-related Efficacy of Abelmoschus Moschatus Preparations in the Treatment of Diabetic Kidney Disease
10.11969/j.issn.1673-548X.2025.02.009
- VernacularTitle:黄葵制剂治疗糖尿病肾病剂量疗效的Meta分析
- Author:
Jia LI
1
;
Su LIU
1
Author Information
1. 210029 南京中医药大学附属医院
- Publication Type:Journal Article
- Keywords:
Abelmoschus moschatus;
Abelmoschus manihot;
Diabetic kidney disease;
Meta-analysis
- From:
Journal of Medical Research
2025;54(2):48-57
- CountryChina
- Language:Chinese
-
Abstract:
Objective Using a Meta-analysis,the efficacy and safety of Abelmoschus moschatus preparations for treating diabetic kidney disease(DKD)were evaluated from the perspectives of disease stage,drug dosage,and course of intervention.Methods Both Chinese and English databases were searched from their inception to June 24,2024,for relevant randomized controlled trial(RCT)on Abelmoschus moschatus preparations in DKD treatment.Endnote 21 software was applied for reference management and filtering,while Co-chrane risk of bias assessment tool and RevMan 5.4 were used for systematic evaluation.Results Initially,a total of 1386 literatures were retrieved in this study,and 28 literatures were finally included after further screening,encompassing a total sample size of 2631 pa-tients.Four types of Abelmoschus moschatus preparations were included:Huangkui capsules,Qikui granules,Jiahua tablets,and Li-uhuang Tangshenkang decoction.The Meta-analysis results showed that Abelmoschus moschatus preparations could reduce multiple indi-cators,such as serum creatinine(SMD=-0.38,95％CI:-0.55--0.21,P＜0.0001)、cystatin C(MD=-0.48,95％CI:-0.63--0.33,P＜0.00001),urinary albumin/creatinine ratio(SMD=-0.74,95％CI:-1.10--0.38,P＜0.0001),urinary albumin excretion rate(SMD=-1.58,95％CI:-1.93--1.24,P＜0.00001)and 24h urine total protein(SMD=-1.00,95％CI:-1.34--0.66,P＜0.00001)in DKD patients,the total clinical effective rate was higher than that of the control group(OR=4.57,95％CI:3.12-6.70,P＜0.00001).The included literatures show that the treatment object of Abelmoschus moschatus prepara-tions was DKD patients at Ⅰ-Ⅳ stage.The dosage of Abelmoschus moschatus preparations ranged from 3-42g,with 30g being the most common,and exceptions as high as 90g in clinical practice,all of which could effectively treat DKD.The course of intervention in the in-cluded literatures was mainly short-term(8-12 weeks),and there were also patients with long-term intervention(≥6months).The overall efficacy of each course of intervention was higher compared with the conventional treatment group.The results of subgroup analysis showed that short-term interventio had the best efficacy on reducing urinary albumin excretion rate and 24h urine total protein,suggesting that Abelmoschus moschatus preparations can play a positive role in the short term.No significant adverse reactions were observed in inter-vention with Abelmoschus moschatus preparations at a dosage range of 3-42g.However,due to the scarcity of literature references on the application of high-dose Abelmoschus moschatus preparations,their safety needs further investigation.Conclusion Abelmoschus mos-chatus preparations can be used for the indication of DKD stages Ⅰ-Ⅳ at a common clinical dosage of 30g(dosage range:3-90g)in common dosage forms of substitutional tea,Chinese patent drug,and decoction of Chinese medicine.Regular administration of Abelmos-chus moschatus preparations can not only help to reduce urine protein,delay renal function decline,but also show fewer adverse reactions of drug,which makes them worthy of being popularized for clinical practices.
