만성신부전에 대한 한약 치료의 효과: 체계적 문헌 고찰 및 메타분석
The Effect of Herbal Medicine for Chronic Kidney Disease: A Systematic Review and Meta-Analysis
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Objectives: This study aimed to evaluate the effect of herbal medicine on patients with non-dialysis chronic kidney disease (CKD). Methods: Articles published from 2011 to February 17, 2024 were searched via PubMed, EMBASE, Cochrane Library, CNKI, CiNii, KISS, RISS, and OASIS. The quality of included articles was evaluated using a risk-of-bias tool. Meta-analyses considered the effects of herbal medicines on the total effective rate, renal function estimates (GFR, SCr, BUN, 24h-Upro), and other indicators (e.g., uric acid, hemoglobin, and bone density-related indicators). Results: A total of 13 RCTs were included in this study. The treatment group showed a significantly higher total effective rate (RR: 1.47, 95% CI: 1.33-1.62, P<0.00001) and GFR (MD: 9.28, 95% CI: 6.52-12.04, P<0.00001), together with improvements in other renal function indicators, except for 24h-Upro (p=0.05). There were no significant differences in uric acid, hemoglobin, and bone density-related indicators. Adverse events were minimal in both groups. Conclusion: For non-dialysis CKD, this study supports the effectiveness of nine herbal medicines, either alone or in combination with Western medicines. However, even the meta-analyses provide insufficient evidence to conclusively guarantee the safety and efficacy of all types of herbal medicines in treating CKD. Therefore, additional well-designed studies are necessary to enhance the clinical application of herbal medicines in CKD.
Abstract
Objectives: This study aimed to evaluate the effect of herbal medicine on patients with non-dialysis chronic kidney disease (CKD). Methods: Articles published from 2011 to February 17, 2024 were searched via PubMed, EMBASE, Cochrane Library, CNKI, CiNii, KISS, RISS, and OASIS. The quality of included articles was evaluated using a risk-of-bias tool. Meta-analyses considered the effects of herbal medicines on the total effective rate, renal function estimates (GFR, SCr, BUN, 24h-Upro), and other indicators (e.g., uric acid, hemoglobin, and bone density-related indicators). Results: A total of 13 RCTs were included in this study. The treatment group showed a significantly higher total effective rate (RR: 1.47, 95% CI: 1.33-1.62, P<0.00001) and GFR (MD: 9.28, 95% CI: 6.52-12.04, P<0.00001), together with improvements in other renal function indicators, except for 24h-Upro (p=0.05). There were no significant differences in uric acid, hemoglobin, and bone density-related indicators. Adverse events were minimal in both groups. Conclusion: For non-dialysis CKD, this study supports the effectiveness of nine herbal medicines, either alone or in combination with Western medicines. However, even the meta-analyses provide insufficient evidence to conclusively guarantee the safety and efficacy of all types of herbal medicines in treating CKD. Therefore, additional well-designed studies are necessary to enhance the clinical application of herbal medicines in CKD.
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