Liuwei Dihuang Pills Enhance the Effect of Western Medicine in Treating Diabetic Nephropathy: A Meta‐Analysis of Randomized Controlled Trials

Objectives. To assess the effectiveness and adverse effects of adding Liuwei Dihuang Pills (LDP) to Western medicine for treating diabetic nephropathy. Methods. Studies were retrieved from seven electronic databases, including PubMed, Embase, The Cochrane Library, CBM, CNKI, Chinese Scientific Journal Database (VIP), and Wanfang Data until November 2015. Study selection, data extraction, quality assessment, and data analyses were conducted according to Cochrane standards. Meta-analysis was performed on the overall therapeutic efficacy of hyperglycemia and renal functions, and the study also analyzed adverse events. Results. A total of 1,275 patients from 18 studies were included. The methodological quality of these included trials was generally low. We found that adding LDP can lower patients' FBG (MD: -0.36 [-0.46, -0.25], P < 0.00001), PBG (MD: -1.10 [-1.35, -0.85], P < 0.00001), and HbA1c (MD: -0.14 [-0.49, 0.21], P = 0.43). There were also improvements in lowering patients' BUN (MD: -0.67 [-0.89, -0.45], P < 0.00001), SCr (MD: -0.96 [-1.53, -0.39], P < 0.00001), 24 h UTP (SMD: -1.26 [-2.38, -0.15], P < 0.00001), UAER (MD: -26.18 [-27.51, -24.85], P < 0.00001), and UmAlb (SMD: -1.72 [-2.67, -0.77], P < 0.00001). Conclusion. There is encouraging evidence that adding LDP to Western medicine might improve treatment outcomes of diabetic nephropathy, including hyperglycemia and renal functions. However, the evidence remains weak. More rigorous high-quality trials are warranted to substantiate or refute the results.