Effects of adding tripterygium glycosides to angiotensin-converting enzyme inhibitors or angiotensin receptor blockers on albuminuria in patients with diabetic nephropathy

作     者：Fang Jin-Ying Yang Yue Zhang Zheng Jiang Shi-Min Yu Tian-Yu Li Wen-Ge Fang Jin-Ying;Yang Yue;Zhang Zheng;Jiang Shi-Min;Yu Tian-Yu;Li Wen-Ge

作者机构：Beijing University of Chinese MedicineBeijing 100029China Department of NephrologyChina-Japan Friendship HospitalBeijing 100029China 

出 版 物：《Chronic Diseases and Translational Medicine》 (慢性疾病与转化医学（英文版）)

年 卷 期：2020年第6卷第1期

页      面：18-26页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：supported by grants from the Science and Technology Project of Beijing(D171100002817003,D171100002817002) National Key R&D Program of China(2016YFC1305500) China Health Promotion Foundation(DKD-MBD project,2018—2022) 

主　　题：Tripterygium glycosides Diabetic nephropathy Angiotensin-converting enzyme inhibitor Angiotensin receptor blockers Metaanalysis 

摘      要：Introduction::Tripterygium glycosides (TGs) have been widely used in China to treat diabetic nephropathy (DN);however, proof of their use is scarce. The present study aimed to evaluate the effectiveness and safety of adding TGs to angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs).Methods::By searching Embase, MEDLINE, Cochrane Library, SINOMED, China National Knowledge Infrastructure, VIP Information/Chinese Scientific Journals, and WANFANG databases, we identified previous studies that met the specific selection criteria and included them in the meta-analysis. Analyses were performed using Review Manager (version 5.3).Results::Nine randomized controlled trials were included in the final meta-analysis. Patients were compared before and after treatment with ACE inhibitors or ARBs plus TGs, or ACE inhibitors or ARBs alone. The results revealed that treatment with ACE inhibitors or ARBs plus TGs resulted in significantly greater reductions in 24-h urinary total protein (UTP) levels (trial duration 6 months, MD: -2.09;95% CI: -2.89, -1.29) compared with treatment using ACE inhibitors or ARBs alone. Additionally, ACE inhibitors or ARBs plus TGs showed better results after longterm administration. Treatment with ACE inhibitors or ARBs plus TGs resulted in significantly greater reductions in serum creatinine (SCr) compared with ACE inhibitors or ARBs alone (MD: -9.87;95% CI: -13.76, -5.97). Conclusion::In patients with DN, adding TGs to ACE inhibitors or ARBs significantly lowered both the 24-h UTP and SCr levels. Therefore, ACE inhibitors or ARBs plus TGs might improve the treatment of DN in patients.