Efficacy of Shenkang injection combined with alprostadil in treatment of diabetic nephropathy:A systematic review

QI Jia; TANG Yue-nian; ZHANG Yu-feng; XIA Qing-qing; JIANG Wei-long

doi:10.3969/j.issn.1002-266X.2015.25.004

Abstract：Objective To systematically evaluate the clinical efficacy and safety of Shenkang injection combined with alprostadil in treatment of diabetic nephropathy .Methods Meta-analysis was used .The literatures of randomized clinical trials ( RCTs) on Shenkang injection combined with alprostadil for diabetic nephropathy in EMBASE , PUBMED, MED-LINE, AMED, CINAHL, Cochrane Library , China National Knowledge Infrastructure Database , Chongqing VIP Chinese Science and Technology Periodical Database , Chinese Biomedical Literature Database and Wanfang Database from the in-ception of each database up to 25 January 2015 were electronically searched .The Cochrane risk of bias tool was used to as-sess the risk of bias .We assessed the quality of included studies using the Jadad rating scale .The Cochrane Collaboration's RevMan5.3 software was used for meta-analysis.All the patients had diabetic nephropathy .Patients in the treatment group were treated with Shenkang injection combined with alprostadil on the basis of the conventional treatment .Patients in the control group was treated with the conventional treatment or the use of other drugs based on the conventional treatment or Shenkang injection alone based on the conventional treatment or alprostadil alone based on the conventional treatment .Re-sults Eleven studies were included and made a meta-analysis.When we compared the treatment group with the control group, the odds ratio(OR) of total efficiency rate was 3.00, 95% confidence interval (CI) was 1.57 to 5.57, and the difference was statistically significant (P=0.00 09);24-hour urinary albumin mean difference (MD) was -0.11, 95%CI[-0.18 to -0.04], and the difference was statistically significant (P=0.002);24-hour urinary micro albumin MD was -122.13, 95%CI[-185.24 to -59.01], and the difference was statistically significant (P=0.000 1);serum cre-atinine MD was -28.07, 95%CI[-35.91 to -20.24], and the difference was statistically significant (P<0.000 01);blood urea nitrogen MD was -2.18, 95%CI[-2.72 to -1.63], and the difference was statistically significant (P<0.000 01);creatinine clearance rate MD was 1.45, 95%CI[0.75 to 2.15], and the difference was statistically signifi-cant (P<0.00 01);total cholesterol MD was -0.79, 95%CI[ -1.12 to -0.46], and the difference was statistically significant (P<0.00 001); urinary albumin excretion rate MD was -40.09, 95%CI[ -63.20 to -16.99], and the difference was statistically significant (P=0.00 07).All studies included did not report any adverse reactions .Conclu-sion Shenkang injection combined with alprostadil in treatment of diabetic nephropathy has significant clinical effect , which reduces the urinary protein , improves the renal function and has good safety .