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. 2022 Apr 25:9:838256.
doi: 10.3389/fmed.2022.838256. eCollection 2022.

Efficacy of Huangqi Injection in the Treatment of Hypertensive Nephropathy: A Systematic Review and Meta-Analysis

ZhongChi Xu  1 , LiChao Qian  2 , RuGe Niu  1 , Ying Yang  1 , ChunLing Liu  1 , Xin Lin  1
Affiliations

Efficacy of Huangqi Injection in the Treatment of Hypertensive Nephropathy: A Systematic Review and Meta-Analysis

ZhongChi Xu et al. Front Med (Lausanne). .

Abstract

Background: Huangqi injection (HQI) is the extract of Astragalus membranaceus (Fisch.) Bunge, which is widely used in the treatment of a variety of diseases in China. It is supposed to be an important adjuvant therapy for hypertensive nephropathy.

Objective: To evaluate the efficacy of HQI combined with antihypertensive drugs in the treatment of hypertensive nephropathy.

Materials and methods: We systematically searched China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database (VIP), Wanfang Knowledge Service Platform (WanfangData), Chinese Biomedical Database (CBM), EMBASE, PubMed and Cochrane Library from their inception to April 23st, 2021. All studies were independently screened by two auditors according to the inclusion and exclusion criteria. Randomized controlled trials comparing HQI in combination with antihypertensive drugs vs. antihypertensive drugs alone were extracted.

Results: The meta-analysis included 15 studies involving 1,483 participants.The effect of HQI combined with antihypertensive drugs is better than that of antihypertensive drugs alone in regulating hypertensive nephropathy for reducing 24-h urinary total protein (24 h UTP) [WMD=-0.29, 95% CI (-0.40, -0.18), P = 0.000], microalbuminuria (mALB) [WMD = -17.04, 95% CI (-23.14, -10.94), P = 0.000], serum creatinine (SCr) [WMD = -40.39, 95% CI (-70.39, -10.39), P = 0.008], systolic blood pressure (SBP) [WMD = -9.50, 95% CI (-14.64, -4.37), P = 0.000], diastolic blood pressure (DBP) [WMD = -4.588, 95% CI (-6.036, -3.140), P = 0.000], cystatin-C (Cys-c) [WMD = -0.854, 95% CI (-0.99, -0.72), P = 0.000], blood urea nitrogen (BUN) [WMD = -4.155, 95% CI (-6.152, -2.157), P = 0.000].

Conclusion: The combination of HQI and antihypertensive drugs is more efficient in improving the related indexes of patients with hypertensive nephropathy than using antihypertensive drugs alone, and a moderate dose of HQI (no more than 30 mL) may benefit more. However, the quality of the methodology is low and the number of samples is small, the results need to be confirmed by more stringent randomized controlled trials.

Keywords: Astragalus membranaceus (Fisch.) Bunge; Huangqi injection; hypertensive nephropathy; meta-analysis; systematic review.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of the process for literature retrieval.
Figure 2
Figure 2
Risk of bias summary.
Figure 3
Figure 3
Forest plot of 24 h UTP.
Figure 4
Figure 4
Subgroups analysis of 24 h UTP.
Figure 5
Figure 5
Forest plot of mALB.
Figure 6
Figure 6
Subgroups analysis of mALB.
Figure 7
Figure 7
Forest plot of Scr.
Figure 8
Figure 8
Subgroups analysis of Scr.
Figure 9
Figure 9
Forest plot of SBP.
Figure 10
Figure 10
Subgroups analysis of SBP.
Figure 11
Figure 11
Forest plot of DBP.
Figure 12
Figure 12
Subgroups analysis of DBP.
Figure 13
Figure 13
Forest plot of Cys-c.
Figure 14
Figure 14
Forest plot of BUN.
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