This study aimed to explore the protective effects of the traditional Chinese Medicine formula Shenkang Ⅶ recipe(SK-7)on renal fibrosis and the mechanisms.Renal fibrosis was induced by unilateral ureteral obstruction...This study aimed to explore the protective effects of the traditional Chinese Medicine formula Shenkang Ⅶ recipe(SK-7)on renal fibrosis and the mechanisms.Renal fibrosis was induced by unilateral ureteral obstruction(UUO)in rats.The rats were then divided into 5 groups:control group(Sham operation),UUO model group,UUO model plus low to high doses of SK-7(0.5,1.0,or 2.0 g/kg/day,for 14 days)groups.The animals were sacrificed on the 7th or 14th day.K idney tissues were collected for histopathological exarminations(hematoxylin and cosin and Masson's trichrome staining).Immunohistochemistry was used to detect the expression of collagen type II(Col II),fibronectin(FN),α-smooth muscle actin(a-SMA),TIMP metallopeptidase inhibitor 2(TIMP2),matrix metallopeptidase 2(MMP2),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)and monocyte chemotactic protein-1(MCP-1).The TGF-β1/Smad,NF-κB and Sonic hedgehog signaling proteins were detected by Western blotting.Our results showed that SK-7 prevented UUO-induced renal injury and accumulation of collagen fibrils.Renal fbrosis biomarkers Col Ⅲ,FN,α-SMA and TMP2 were increased in the rats after UUO and decreased by SK-7,while MMP2 was upregulated after treatment.SK-7 also suppressed the levels of TNF-α,IL-1βand MCP-1 in UUO rats.In addition,SK-7 inhibited activation of the TGF-B/Smad,NF-κB and sonic hedgehog signaling(SHH)pathways.Taken together,these findings suggest that SK-7 may regulate the synthesis and degradation of extracellular matrix,reduce inflammation and suppress the proliferation of fibroblasts,by blocking the TGF-β1/Smad,NF-κB and SHH signaling pathways to exert its anti-renal fbrosis effect in UUO rats.展开更多
Objective: To investigate the effect of Shenkang granule combined with Atorvastatin on renal function, urinary protein and coagulation function in patients with chronic nephritis. Methods:A total of 100 patients with ...Objective: To investigate the effect of Shenkang granule combined with Atorvastatin on renal function, urinary protein and coagulation function in patients with chronic nephritis. Methods:A total of 100 patients with chronic nephritis who were treated in our hospital between May 2016 to May 2017 were randomly divided into control group and observation group, 50 cases in each group. Patients in the control group were treated with Atorvastatin, while patients in the observation group were treated with Shenkang granule on the basis of the treatment in the control group. The changes of renal function, coagulation function and inflammatory factors were detected and compared between the patients in the two groups before and after treatment. Result: After treatment, the levels of Cr, BUN and 24hUpro in serum of patients in the two groups were significantly decreased, and the levels of ALB were significantly increased, and the changes of the above factors of patients in the observation group were more obvious. After treatment, the levels of PT, APTT and TT of patients in the two groups were significantly increased, and the levels of FIB were significantly decreased, and the changes of the above indexes of patients in the observation group were more obvious. After treatment, the levels of hs-CRP and TNF-α in serum of patients in the two groups were significantly decreased, and the decrease trend of inflammatory factors of patients in the observation group was more obvious. Conclusion: Shenkang granule combined with Atorvastatin has a good effect on treatment of chronic nephritis. It can significantly improve renal function and coagulation function, alleviate inflammation, and has a certain protective effect on kidney of patients.展开更多
OBJECTIVE: To explore the effects of Shenkang Injection combined with hemodialysis on dialysis rate and nutriture in patients with chronic renal failure (CRF).METHODS: A total of 110 CRF patients admitted in the hospi...OBJECTIVE: To explore the effects of Shenkang Injection combined with hemodialysis on dialysis rate and nutriture in patients with chronic renal failure (CRF).METHODS: A total of 110 CRF patients admitted in the hospital from January 2016 to January 2018 were randomly divided into 2 groups.The control group was treated with hemodialysis while the observation group was additionally treated with Shenkang Injection on the treatment basis of the control group.They were treated for 4 weeks and reexamined 1 d after the treatment.Renal function,nutriture,dialysis adequacy,oxidative stress level and inflammatory factor level in the 2 groups were determined before and after the treatment,and traditional Chinese medicine (TCM) syndrome score,dialysis rate within 1 week and incidence of adverse reactions during the treatment were counted before and after the treatment.RESULTS: After the treatment,the levels of serum creatinine (Scr) and urea nitrogen (BUN) in the observation group were lower than those in the control group,and the endogenous creatinine clearance rate (Ccr) was higher than that in the control group (P < 0.05).After the treatment,the nutriture in the observation group was better than that in the control group (P < 0.05).After the treatment,the dialysis rate and time average concentration of urea (TACurea) in the observation group were lower than those in the control group,while the overall urea clearance rate (Kt/V) and protein catabolic rate (PCR) were higher than those in the control group (P < 0.05).After the treatment,the TCM syndrome scores in the observation group was lower than that in the control group (P < 0.05) and the level of serum malondialdehyde (MDA) in the observation group was lower than that in the control,while the level of superoxide dismutase (SOD) and total antioxidant capacity (T-AOC) in the observation group were higher than those in the control group (P < 0.05).After the treatment,the levels of inflammatory factors in the observation group were lower than those in the control group (P < 0.05).No serious adverse reactions occurred in the 2 groups.CONCLUSION: Shenkang Injection combined with hemodialysis for the treatment of CRF can effectively improve clinical symptoms and nutriture,and reduce the dialysis rate.展开更多
Objective:The purpose of the research was to systematically evaluate the clinical efficacy and safety of Shenkang injection combined with Western medicine in treating chronic glomerulonephritis.Methods:Randomized cont...Objective:The purpose of the research was to systematically evaluate the clinical efficacy and safety of Shenkang injection combined with Western medicine in treating chronic glomerulonephritis.Methods:Randomized controlled trials of Shenkang Injection combined with Western medicine in treating CGN were obtained from 8 Science databases including China National Knowledge Infrastructure(CNKI),China Biomedical Database(SinMed),Weipu Database(VIP),Wanfang Database(Wanfang),PubMed,The Cochrane Library,Embase,Web of Science from establishment to June 2022.Two researchers screened literature and extracted useful data according to inclusion and exclusion criteria,and used RevMan 5.3 and STATA SE 14.0 software to perform meta-analysis.Results:1,214 patients were included in 15 studies,with 607 in treatment group and 607 in control group.The results of meta-analysis showed that the treatment group could improve the clinical effective rate[RR=1.33,95%CI(1.25,1.40),P<0.00001],reduce serum creatinine[MD=-31.28,95%CI(-42.90,-19.66),P<0.00001],blood urea nitrogen[MD=-2.26,95%CI(-3.08,-1.44),P<0.00001],24-hour urine protein quantification[MD=-0.37,95%CI(-0.49,-0.25),P<0.00001],tumor necrosis factor-α[MD=-7.93,95%CI(-10.56,-5.30),P<0.00001],systolic blood pressure[MD=-10.81,95%CI(-13.66,-7.96),P<0.00001]and diastolic blood pressure[MD=-7.36,95%CI(-9.34,-5.38),P<0.00001].Conclusion:Shenkang injection combined with Western medicine can enhance the clinical effective rate of CGN and reduce the levels of serum creatinine,blood urea nitrogen,24-hour urine protein quantification,tumor necrosis factor-α,systolic blood and diastolic blood pressure.However,due to the low quality of literature,the conclusion still needs to be supported by more multi-center,large-sample studies with rigorous design and standardized implementation.展开更多
Shenkang injection (SKI) is a classic prescription composed of Radix Astragali, rhubarb, Astragalus, Safflower, and Salvia. This treatment was approved by the State Food and Drug Administration of China in 1999 for tr...Shenkang injection (SKI) is a classic prescription composed of Radix Astragali, rhubarb, Astragalus, Safflower, and Salvia. This treatment was approved by the State Food and Drug Administration of China in 1999 for treatment of chronic kidney diseases based on good efficacy and safety. This study aimed to investigate the protective effect of SKI against high glucose (HG)-induced renal tubular cell senescence and its underlying mechanism. Primary renal proximal tubule epithelial cells were cultured in (1) control medium (control group), medium containing 5 mmol/L glucose;(2) mannitol medium (mannitol group), medium containing 5 mmol/L glucose, and 25 mmol/L mannitol;(3) HG medium (HG group) containing 30 mmol/L glucose;(4) SKI treatment at high (200 mg/L), medium (100 mg/L), or low (50 mg/L) concentration in HG medium (HG+ SKI group);or (5) 200 mg/L SKI treatment in control medium (control+ SKI group) for 72 h. HG-induced senescent cells showed the emergence of senescence associated heterochromatin foci, up-regulation of P16INK4 and cyclin D1, increased senescence-associated β-galactosidase activity, and elevated expression of membrane decoy receptor 2. SKI treatment potently prevented these changes in a dose-independent manner. SKI treatment prevented HG-induced up-regulation of pro-senescence molecule mammalian target of rapamycin and p66Shc and down-regulation of anti-senescence molecules klotho, sirt1, and peroxisome proliferator-activated receptor-g in renal tubular epithelial cells. SKI may be a novel strategy for protecting against HG-induced renal tubular cell senescence in treatment of diabetic nephropathy.展开更多
OBJECTIVE: To investigate the effect of Shenkang injection(SKI) on chronic kidney disease(CKD).METHODS: Seven databases including Cochrane Central Register of Controlled Trials, PubMed, EMBASE, MEDLINE, China National...OBJECTIVE: To investigate the effect of Shenkang injection(SKI) on chronic kidney disease(CKD).METHODS: Seven databases including Cochrane Central Register of Controlled Trials, PubMed, EMBASE, MEDLINE, China National Knowledge Infrastructure, Wanfang Database, and CQVIP from their inception to March 2018 were searched. Only randomized controlled trials that evaluated conventional treatment and conventional treatment with SKI in CKD patients were investigated. Outcomes such as fibrinogen(FIB), D-dimer, prothrombin time(PT), activated partial thromboplastin time(APTT), and the side effects of SKI were analyzed using Revman 5.3 software. The quality of the studies was assessed using the Cochrane Collaboration’s Risk of Bias tool and the quality of evidence was assessed using GRADEpro.RESULTS: Four randomized controlled trials were investigated in our analysis, and these studies were of moderate quality. For FIB and D-dimer, SKI had a superior effect compared with the control group(mean difference(MD)=-1.23, 95% confidence interval(CI):-1.46,-0.99, P < 0.01;MD =-0.36, 95%CI:-0.51,-0.21, P < 0.01, respectively)SKI increased APTT and PT compared with the control(MD = 7.34, 95% CI: 3.05, 11.62, P < 0.01;MD = 3.40,95% CI: 2.2, 4.61, P < 0.01, respectively). In the four studies, there were no side effects that were related to SKI.CONCLUSION: SKI may be effective in improving coagulation in patients with CKD without obvious adverse reactions. However, more well-designed studies are required to confirm the findings.展开更多
Objective:To investigate the protective effects and possible mechanisms of Shenkang Injection(SKI)on the diabetic nephropathy in streptozotocin-induced mice.Methods:STZ with the feeding of high fat diet(HFD)was used t...Objective:To investigate the protective effects and possible mechanisms of Shenkang Injection(SKI)on the diabetic nephropathy in streptozotocin-induced mice.Methods:STZ with the feeding of high fat diet(HFD)was used to induce diabetic mice.The balb/c mice and diabetic mice were then randomly divided into five groups:(1)control group,(2)model group,(3)alprostadil(Alp,1.5μg/kg)group,(4)SKI(30 ml/kg)group,(5)Alp(1.5μg/kg)+SKI(15 ml/kg)group.After six weeks'treatment,blood,urine and kidney tissues were collected for biochemical assay,EUSA assay,and pathological analysis.Results:Diabetic mice exhibited evident manifestations of diabetic nephropathy(DN),as indicated by increased 24-h urine volume,urinary albumin and kidney weight index(P<0.01),which could be attenuated by SKI treatment(P<0.01).SKI was further found to improve abnormal morphology in glomerulus with increased glomerular volume and to decrease urinary N-acetyl-b-D-glucpsaminidase(NAG),β2-microglobulin(β2-MG),and kidney injury molecules-1(KIM-1)levels(P<0.05,P<0.01).Plasma levels of anti-oxidant enzymes significantly reduced in the diabetic mice,and those decreases could be reversed by SKI and Alp treatments.Additionally,SKI obviously suppressed the diabetes-induced increases of proinflammatory cytokines(IL-6,IL-1βand TNF-α)(P<0.01).Meanwhile,SKI was found to effectively attenuate the diabetes-induced coagulation dysfunction,as evidenced by lengthening prothrombin and thrombin time,and decreasing plasma levels of fibrinogen(FIB),6-K-PGF1αand thromboxane B2(TXB2)(P<0.05,P<0.01).With SKI and Alp combined treatment,the anti-oxidant activities and improvements of coagulation dysfunction were enhanced.Conclusion:SKI possesses a remarkable property to prevent diabetic nephropathy.The improvements of kidney function and hypercoagulability by SKI were enhanced with Alp combined treatment.The molecular mechanisms underlying the protection of SKI against DN may be related to enhancing the antioxidant and anti-inflammatory activities,and improving the coagulation dysfunction.展开更多
目的系统评价肾康注射液联合西药治疗肾病综合征的临床疗效及安全性。方法检索中国知网、万方数据库、维普中文数据库、中国生物医学文献服务系统、Web of Science、Embase、PubMed及Cochrane Library数据库自建库至2022年6月30日期间...目的系统评价肾康注射液联合西药治疗肾病综合征的临床疗效及安全性。方法检索中国知网、万方数据库、维普中文数据库、中国生物医学文献服务系统、Web of Science、Embase、PubMed及Cochrane Library数据库自建库至2022年6月30日期间所有肾康注射液联合西药治疗肾病综合征(Nephrotic syndrome,NS)的随机对照试验(Randomized controlled trial,RCT),并由两名研究人员提取资料并进行质量评价,采用Review Manager 5.4.1软件和R语言进行Meta分析。结果共纳入19篇文献,涉及1509例患者,治疗组763例,对照组746例。Meta分析结果显示:肾康注射液联合西药较单纯西药治疗肾病综合征可以显著提高临床总有效率[RR=1.27,95%CI(1.20;1.34),P<0.00001]、内生肌酐清除率(Creatinine clearance rate,Ccr)[MD=6.36,95%CI(3.04;9.68),P=0.0002]、血浆白蛋白(Plasma Albumin,ALB)[MD=4.94,95%CI(3.23;6.64),P<0.00001]水平,能有效降低甘油三酯(Triglycerides,TG)[MD=-0.86,95%CI(-1.05;-0.67),P<0.00001]、总胆固醇(Total cholesterol,TC)[MD=-1.44,95%CI(-2.14;-0.74),P<0.00001]、血清肌酐(Serum creatinine,Scr)[MD=-33.60,95%CI(-67.03;-0.17),P<0.00001]、尿素氮(Urea nitrogen,BUN)[MD=-2.47,95%CI(-2.89;-2.05),P<0.00001]、24 h尿蛋白定量(24 h urine total protein,24 h UTP)[MD=-0.57,95%CI(-0.78;-0.35),P<0.00001]水平,且差异有统计学意义。结论肾康注射液联合西药可以提高肾病综合征患者的临床总有效率,提高Ccr和ALB,能有效降低TG、低胆固醇、Scr、BUN和24 h UTP,在一定程度上可以减少肾病综合征患者的肾功能的损伤。展开更多
基金This study was supported by Academic Experience Inheritance of the Sixth National Group of Old Chinese Medicine Experts of the State Administration of Traditional Chinese Medicine(No.2017[29])the key projects of Hubei Provincial Department of Health(No.JX6A09).
文摘This study aimed to explore the protective effects of the traditional Chinese Medicine formula Shenkang Ⅶ recipe(SK-7)on renal fibrosis and the mechanisms.Renal fibrosis was induced by unilateral ureteral obstruction(UUO)in rats.The rats were then divided into 5 groups:control group(Sham operation),UUO model group,UUO model plus low to high doses of SK-7(0.5,1.0,or 2.0 g/kg/day,for 14 days)groups.The animals were sacrificed on the 7th or 14th day.K idney tissues were collected for histopathological exarminations(hematoxylin and cosin and Masson's trichrome staining).Immunohistochemistry was used to detect the expression of collagen type II(Col II),fibronectin(FN),α-smooth muscle actin(a-SMA),TIMP metallopeptidase inhibitor 2(TIMP2),matrix metallopeptidase 2(MMP2),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)and monocyte chemotactic protein-1(MCP-1).The TGF-β1/Smad,NF-κB and Sonic hedgehog signaling proteins were detected by Western blotting.Our results showed that SK-7 prevented UUO-induced renal injury and accumulation of collagen fibrils.Renal fbrosis biomarkers Col Ⅲ,FN,α-SMA and TMP2 were increased in the rats after UUO and decreased by SK-7,while MMP2 was upregulated after treatment.SK-7 also suppressed the levels of TNF-α,IL-1βand MCP-1 in UUO rats.In addition,SK-7 inhibited activation of the TGF-B/Smad,NF-κB and sonic hedgehog signaling(SHH)pathways.Taken together,these findings suggest that SK-7 may regulate the synthesis and degradation of extracellular matrix,reduce inflammation and suppress the proliferation of fibroblasts,by blocking the TGF-β1/Smad,NF-κB and SHH signaling pathways to exert its anti-renal fbrosis effect in UUO rats.
基金the Natural Science Foundation of Qinghai Province(2011-ZR-701).
文摘Objective: To investigate the effect of Shenkang granule combined with Atorvastatin on renal function, urinary protein and coagulation function in patients with chronic nephritis. Methods:A total of 100 patients with chronic nephritis who were treated in our hospital between May 2016 to May 2017 were randomly divided into control group and observation group, 50 cases in each group. Patients in the control group were treated with Atorvastatin, while patients in the observation group were treated with Shenkang granule on the basis of the treatment in the control group. The changes of renal function, coagulation function and inflammatory factors were detected and compared between the patients in the two groups before and after treatment. Result: After treatment, the levels of Cr, BUN and 24hUpro in serum of patients in the two groups were significantly decreased, and the levels of ALB were significantly increased, and the changes of the above factors of patients in the observation group were more obvious. After treatment, the levels of PT, APTT and TT of patients in the two groups were significantly increased, and the levels of FIB were significantly decreased, and the changes of the above indexes of patients in the observation group were more obvious. After treatment, the levels of hs-CRP and TNF-α in serum of patients in the two groups were significantly decreased, and the decrease trend of inflammatory factors of patients in the observation group was more obvious. Conclusion: Shenkang granule combined with Atorvastatin has a good effect on treatment of chronic nephritis. It can significantly improve renal function and coagulation function, alleviate inflammation, and has a certain protective effect on kidney of patients.
文摘OBJECTIVE: To explore the effects of Shenkang Injection combined with hemodialysis on dialysis rate and nutriture in patients with chronic renal failure (CRF).METHODS: A total of 110 CRF patients admitted in the hospital from January 2016 to January 2018 were randomly divided into 2 groups.The control group was treated with hemodialysis while the observation group was additionally treated with Shenkang Injection on the treatment basis of the control group.They were treated for 4 weeks and reexamined 1 d after the treatment.Renal function,nutriture,dialysis adequacy,oxidative stress level and inflammatory factor level in the 2 groups were determined before and after the treatment,and traditional Chinese medicine (TCM) syndrome score,dialysis rate within 1 week and incidence of adverse reactions during the treatment were counted before and after the treatment.RESULTS: After the treatment,the levels of serum creatinine (Scr) and urea nitrogen (BUN) in the observation group were lower than those in the control group,and the endogenous creatinine clearance rate (Ccr) was higher than that in the control group (P < 0.05).After the treatment,the nutriture in the observation group was better than that in the control group (P < 0.05).After the treatment,the dialysis rate and time average concentration of urea (TACurea) in the observation group were lower than those in the control group,while the overall urea clearance rate (Kt/V) and protein catabolic rate (PCR) were higher than those in the control group (P < 0.05).After the treatment,the TCM syndrome scores in the observation group was lower than that in the control group (P < 0.05) and the level of serum malondialdehyde (MDA) in the observation group was lower than that in the control,while the level of superoxide dismutase (SOD) and total antioxidant capacity (T-AOC) in the observation group were higher than those in the control group (P < 0.05).After the treatment,the levels of inflammatory factors in the observation group were lower than those in the control group (P < 0.05).No serious adverse reactions occurred in the 2 groups.CONCLUSION: Shenkang Injection combined with hemodialysis for the treatment of CRF can effectively improve clinical symptoms and nutriture,and reduce the dialysis rate.
基金the Youth Fund Project of National Natural Science Foundation of China(No.81904141)National Key Research and Development Program of China,"Modernization of Traditional Chinese Medicine"(No.2019YFC1709400).
文摘Objective:The purpose of the research was to systematically evaluate the clinical efficacy and safety of Shenkang injection combined with Western medicine in treating chronic glomerulonephritis.Methods:Randomized controlled trials of Shenkang Injection combined with Western medicine in treating CGN were obtained from 8 Science databases including China National Knowledge Infrastructure(CNKI),China Biomedical Database(SinMed),Weipu Database(VIP),Wanfang Database(Wanfang),PubMed,The Cochrane Library,Embase,Web of Science from establishment to June 2022.Two researchers screened literature and extracted useful data according to inclusion and exclusion criteria,and used RevMan 5.3 and STATA SE 14.0 software to perform meta-analysis.Results:1,214 patients were included in 15 studies,with 607 in treatment group and 607 in control group.The results of meta-analysis showed that the treatment group could improve the clinical effective rate[RR=1.33,95%CI(1.25,1.40),P<0.00001],reduce serum creatinine[MD=-31.28,95%CI(-42.90,-19.66),P<0.00001],blood urea nitrogen[MD=-2.26,95%CI(-3.08,-1.44),P<0.00001],24-hour urine protein quantification[MD=-0.37,95%CI(-0.49,-0.25),P<0.00001],tumor necrosis factor-α[MD=-7.93,95%CI(-10.56,-5.30),P<0.00001],systolic blood pressure[MD=-10.81,95%CI(-13.66,-7.96),P<0.00001]and diastolic blood pressure[MD=-7.36,95%CI(-9.34,-5.38),P<0.00001].Conclusion:Shenkang injection combined with Western medicine can enhance the clinical effective rate of CGN and reduce the levels of serum creatinine,blood urea nitrogen,24-hour urine protein quantification,tumor necrosis factor-α,systolic blood and diastolic blood pressure.However,due to the low quality of literature,the conclusion still needs to be supported by more multi-center,large-sample studies with rigorous design and standardized implementation.
文摘Shenkang injection (SKI) is a classic prescription composed of Radix Astragali, rhubarb, Astragalus, Safflower, and Salvia. This treatment was approved by the State Food and Drug Administration of China in 1999 for treatment of chronic kidney diseases based on good efficacy and safety. This study aimed to investigate the protective effect of SKI against high glucose (HG)-induced renal tubular cell senescence and its underlying mechanism. Primary renal proximal tubule epithelial cells were cultured in (1) control medium (control group), medium containing 5 mmol/L glucose;(2) mannitol medium (mannitol group), medium containing 5 mmol/L glucose, and 25 mmol/L mannitol;(3) HG medium (HG group) containing 30 mmol/L glucose;(4) SKI treatment at high (200 mg/L), medium (100 mg/L), or low (50 mg/L) concentration in HG medium (HG+ SKI group);or (5) 200 mg/L SKI treatment in control medium (control+ SKI group) for 72 h. HG-induced senescent cells showed the emergence of senescence associated heterochromatin foci, up-regulation of P16INK4 and cyclin D1, increased senescence-associated β-galactosidase activity, and elevated expression of membrane decoy receptor 2. SKI treatment potently prevented these changes in a dose-independent manner. SKI treatment prevented HG-induced up-regulation of pro-senescence molecule mammalian target of rapamycin and p66Shc and down-regulation of anti-senescence molecules klotho, sirt1, and peroxisome proliferator-activated receptor-g in renal tubular epithelial cells. SKI may be a novel strategy for protecting against HG-induced renal tubular cell senescence in treatment of diabetic nephropathy.
基金Supported by Effect and Mechanism Of Shenkang Injection on Chronic Kidney Disease(2019-ZXFZJJ-001)
文摘OBJECTIVE: To investigate the effect of Shenkang injection(SKI) on chronic kidney disease(CKD).METHODS: Seven databases including Cochrane Central Register of Controlled Trials, PubMed, EMBASE, MEDLINE, China National Knowledge Infrastructure, Wanfang Database, and CQVIP from their inception to March 2018 were searched. Only randomized controlled trials that evaluated conventional treatment and conventional treatment with SKI in CKD patients were investigated. Outcomes such as fibrinogen(FIB), D-dimer, prothrombin time(PT), activated partial thromboplastin time(APTT), and the side effects of SKI were analyzed using Revman 5.3 software. The quality of the studies was assessed using the Cochrane Collaboration’s Risk of Bias tool and the quality of evidence was assessed using GRADEpro.RESULTS: Four randomized controlled trials were investigated in our analysis, and these studies were of moderate quality. For FIB and D-dimer, SKI had a superior effect compared with the control group(mean difference(MD)=-1.23, 95% confidence interval(CI):-1.46,-0.99, P < 0.01;MD =-0.36, 95%CI:-0.51,-0.21, P < 0.01, respectively)SKI increased APTT and PT compared with the control(MD = 7.34, 95% CI: 3.05, 11.62, P < 0.01;MD = 3.40,95% CI: 2.2, 4.61, P < 0.01, respectively). In the four studies, there were no side effects that were related to SKI.CONCLUSION: SKI may be effective in improving coagulation in patients with CKD without obvious adverse reactions. However, more well-designed studies are required to confirm the findings.
基金This work was supported by the National Key R&D Plan(No.2018YFC1707408).
文摘Objective:To investigate the protective effects and possible mechanisms of Shenkang Injection(SKI)on the diabetic nephropathy in streptozotocin-induced mice.Methods:STZ with the feeding of high fat diet(HFD)was used to induce diabetic mice.The balb/c mice and diabetic mice were then randomly divided into five groups:(1)control group,(2)model group,(3)alprostadil(Alp,1.5μg/kg)group,(4)SKI(30 ml/kg)group,(5)Alp(1.5μg/kg)+SKI(15 ml/kg)group.After six weeks'treatment,blood,urine and kidney tissues were collected for biochemical assay,EUSA assay,and pathological analysis.Results:Diabetic mice exhibited evident manifestations of diabetic nephropathy(DN),as indicated by increased 24-h urine volume,urinary albumin and kidney weight index(P<0.01),which could be attenuated by SKI treatment(P<0.01).SKI was further found to improve abnormal morphology in glomerulus with increased glomerular volume and to decrease urinary N-acetyl-b-D-glucpsaminidase(NAG),β2-microglobulin(β2-MG),and kidney injury molecules-1(KIM-1)levels(P<0.05,P<0.01).Plasma levels of anti-oxidant enzymes significantly reduced in the diabetic mice,and those decreases could be reversed by SKI and Alp treatments.Additionally,SKI obviously suppressed the diabetes-induced increases of proinflammatory cytokines(IL-6,IL-1βand TNF-α)(P<0.01).Meanwhile,SKI was found to effectively attenuate the diabetes-induced coagulation dysfunction,as evidenced by lengthening prothrombin and thrombin time,and decreasing plasma levels of fibrinogen(FIB),6-K-PGF1αand thromboxane B2(TXB2)(P<0.05,P<0.01).With SKI and Alp combined treatment,the anti-oxidant activities and improvements of coagulation dysfunction were enhanced.Conclusion:SKI possesses a remarkable property to prevent diabetic nephropathy.The improvements of kidney function and hypercoagulability by SKI were enhanced with Alp combined treatment.The molecular mechanisms underlying the protection of SKI against DN may be related to enhancing the antioxidant and anti-inflammatory activities,and improving the coagulation dysfunction.
文摘目的系统评价肾康注射液联合西药治疗肾病综合征的临床疗效及安全性。方法检索中国知网、万方数据库、维普中文数据库、中国生物医学文献服务系统、Web of Science、Embase、PubMed及Cochrane Library数据库自建库至2022年6月30日期间所有肾康注射液联合西药治疗肾病综合征(Nephrotic syndrome,NS)的随机对照试验(Randomized controlled trial,RCT),并由两名研究人员提取资料并进行质量评价,采用Review Manager 5.4.1软件和R语言进行Meta分析。结果共纳入19篇文献,涉及1509例患者,治疗组763例,对照组746例。Meta分析结果显示:肾康注射液联合西药较单纯西药治疗肾病综合征可以显著提高临床总有效率[RR=1.27,95%CI(1.20;1.34),P<0.00001]、内生肌酐清除率(Creatinine clearance rate,Ccr)[MD=6.36,95%CI(3.04;9.68),P=0.0002]、血浆白蛋白(Plasma Albumin,ALB)[MD=4.94,95%CI(3.23;6.64),P<0.00001]水平,能有效降低甘油三酯(Triglycerides,TG)[MD=-0.86,95%CI(-1.05;-0.67),P<0.00001]、总胆固醇(Total cholesterol,TC)[MD=-1.44,95%CI(-2.14;-0.74),P<0.00001]、血清肌酐(Serum creatinine,Scr)[MD=-33.60,95%CI(-67.03;-0.17),P<0.00001]、尿素氮(Urea nitrogen,BUN)[MD=-2.47,95%CI(-2.89;-2.05),P<0.00001]、24 h尿蛋白定量(24 h urine total protein,24 h UTP)[MD=-0.57,95%CI(-0.78;-0.35),P<0.00001]水平,且差异有统计学意义。结论肾康注射液联合西药可以提高肾病综合征患者的临床总有效率,提高Ccr和ALB,能有效降低TG、低胆固醇、Scr、BUN和24 h UTP,在一定程度上可以减少肾病综合征患者的肾功能的损伤。
