scholarly journals Clinical efficacy and safety of tripterygium glycosides in treatment of stage IV diabetic nephropathy: A meta-analysis

Open Medicine ◽  
2016 ◽  
Vol 11 (1) ◽  
pp. 611-617 ◽  
Author(s):  
Yan Hong ◽  
Zhihong Gui ◽  
Xiaoping Cai ◽  
Lejian lan
Keyword(s):  
Diabetic Nephropathy ◽  
Serum Creatinine ◽  
Clinical Efficacy ◽  
Stage Iv ◽  
Post Treatment ◽  
Urinary Protein ◽  
Control Group ◽  
Efficacy And Safety ◽  
Statistical Heterogeneity ◽  
Tripterygium Glycosides

AbstractThe aim of this meta-analysis was to evaluate the clinical efficacy and safety of tripterygium glycosides in treatment of stage IV diabetic nephropathy. Methods Through searching the PubMed and CNKI databases, the open published clinically controlled trials related to efficacy and safety of tripterygium glycosides in the treatment of stage IV diabetic nephropathy were collected. The pooled total efficacy, 24h urinary protein, serum creatinine and tripterygium glycosides related toxicity were calculated using Stata 11.0 software. Results Fourteen publications including 992 subjects (512 in the experimental group and 480 in the control group) were included in this study. Eight studies reported the total clinical efficacy comparing the experiment and control groups. No significant statistical heterogeneity was found in total efficacy (I2=24.9%, p>0.05). Thus, the combined odds ratio (OR) was pooled by fixed effect model. The pooled OR=4.16 with its 95% CI 2.71~6.37 (p<0.05), which indicated the total efficacy in the experiment group, was significant higher than that of control group (p<0.05); Thirteen studies reported the post-treatment 24h urinary protein value. Statistical heterogeneity analysis indicated significant heterogeneity across studies (I2=91.1%, p<0.05); that data was pooled by a random effects model. The combined standardized mean difference (SMD) was -1.55 with its 95% I -2.06~1.03, (p<0.05). The results indicated that post-treatment 24h urinary protein in the experiment group was significant lower than that in control group (p<0.05); Ten studies reported the post-treatment serum creatinine. Significant heterogeneity existed across those studies (I2=82.3%, p<0.05). Thereafter, the data was pooled by a random effect model. The combined standardized mean difference (SMD) was −0.24 with its 95%CI −0.40~0.09, (p<0.05). The results indicated that the post-treatment serum creatinine in experiment group was significant lower than that of control group (p<0.05); Eight studies reported tripterygium glycoside-associated toxicity such as liver function damage, gastrointestinal reactions and menstrual disorders. With no statistical heterogeneity among the studies, the data was pooled by fixed effect model. The pooled OR=6.42 (95%CI 2.23~18.48, p<0.05). The pooled results showed the tripterygium glycoside- associated toxicity incidence rate was significant higher in the experiment group than that of the control group (p<0.05); There were no publication bias for effect size of total efficacy, 24h urinary protein, and serum creatinine. However, for tripterygium glycoside-related toxicity, the publication bias was significant (t=-3.55, p<0.05). Conclusion The present evidence shows that tripterygium glycosides can improve clinical efficacy, reduce the 24h urinary protein and serum creatinine, but that they increase the tripterygium glycoside-related toxicity in treatment of stage IV diabetic nephropathy.

scholarly journals Clinical efficacy of linagliptin combined with irbesartan in patients with diabetic nephropathy

2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Jie Liu ◽  
Jing Zhang ◽  
Ming-hui Hou ◽  
Wei-xuan Du
Keyword(s):  
Diabetic Nephropathy ◽  
Treatment Group ◽  
Clinical Efficacy ◽  
Stress Responses ◽  
Fasting Blood Glucose ◽  
Post Treatment ◽  
Control Group ◽  
Combined Modality Treatment ◽  
Creative Commons ◽  
Urine Albumin

Objective: To determine the clinical efficacy of linagliptin combined with irbesartan in patients with diabetic nephropathy (DN). Methods: Seventy-two patients who were admitted to our department of endocrinology in our hospital during January 2018 and June 2019 were randomly divided into a control group (administered with irbesartan only, n=36) and a treatment group (treated with irbesartan and linagliptin, n=36). The course of treatment lasted for three months. FBG (fasting blood glucose), 2hPBG (2h postprandial blood sugar), HbA1C (hemoglobin A1c), Cys-C (cystatin C), SCr (serum creatinine), BUN (blood urea nitrogen), UACR (urine albumin-to-creatinine ratio), CRP (C-reactive protein), IL-6 (interleukin-6), and SOD (superoxide dismutase) were tested pre- and post-treatment to evaluate the clinical efficacy and adverse effects of the two treatment plans after three months of treatment. Results: Compared with the pre-treatment levels, FBG, 2hPBG, HbA1c, Cys-C, SCr, BUN, UACR, CRP, IL-6, and SOD in both groups were significantly improved following the three-month treatment (P<0.05, respectively). Post-treatment levels of FBG, 2hPBG, HbA1c, Cys-C, SCr, BUN, UACR, CRP, and IL-6 in the treatment group were significantly lower than in the control group (P<0.05, respectively), while the treatment group exhibited a higher level of SOD compared with the control group (P<0.05). No serious adverse reaction occurred in either group (P>0.05). Conclusion: Combined-modality treatment with linagliptin and irbesartan shows favorable clinical efficacy in treating diabetic nephropathy as it effectively protects the kidneys and improves kidney function by inhibiting inflammatory and oxidative stress responses. doi: https://doi.org/10.12669/pjms.38.1.4417 How to cite this:Liu J, Zhang J, Hou M, Du W. Clinical efficacy of linagliptin combined with irbesartan in patients with diabetic nephropathy. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.4417 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Meta-Analysis of Clinical Efficacy and Safety of Ligustrazine in the Treatment of Idiopathic Pulmonary Fibrosis

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Xiaozheng Wu ◽  
Wen Li ◽  
Zhenliang Luo ◽  
Yunzhi Chen
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Clinical Efficacy ◽  
Adverse Reactions ◽  
Clinical Symptoms ◽  
Gas Analysis ◽  
Control Group ◽  
Efficacy And Safety ◽  
Arterial Blood Gas ◽  
Arterial Blood

Objective. To systematically review the efficacy and safety of Ligustrazine in the treatment of idiopathic pulmonary fibrosis (IPF). Methods. The electronic literature databases (PubMed, EMbase, CNKI, WanFang database, and VIP) were retrieved through a computer to find out the randomized controlled trials (RCT) of Ligustrazine in the treatment of IPF according to the inclusion/exclusion criteria screening test. Cochrane’s bias risk table was also used to evaluate the quality of the study and to extract effective data. RevMan 5.3 was used for statistical analysis. Results. A total of 7 RCTs (a total of 366 patients, including 196 in experimental and 170 in control group). Compared with the control group, Ligustrazine could improve the clinical symptoms ([OR] = 2.20, 95% CI [1.40, 3.46], P = 0.0006 ), lung function (VC % [MD] = 3.92, 95% CI [0.68, 7.17], P = 0.02 ), (TLC% [MD] = 4.94, 95% CI [0.37, 9.52], P = 0.03 ), the pulmonary diffusion function (DLCO % [MD] = 9.12, 95% CI [5.70, 12.55], P < 0.00001 ), and arterial blood gas analysis (PaO2 [MD] = 7.11, 95% CI [1.96, 12.25], P = 0.007 ) (PaCO2 [MD] = −2.42, 95% CI [−4.36, −0.49], P = 0.01 ) of IPF patients, respectively. However, FEV1/FVC % ([MD] = 9.37, 95% CI [−1.23, 19.97], P = 0.08 ) and adverse reactions ([MD] = 0.35, 95% CI [0.02, 5.36], P = 0.45 ) were not significantly improved. Conclusion. Ligustrazine has certain clinical efficacy in the treatment of IPF, but the safety of applying it and the adverse reactions need to be further analyzed and determined. It can be considered as a new alternative and complementary medicine to be promoted and recommended for use in medical units in various countries in the world and it solved the difficult problem of conventional drug treatment of IPF; therefore, more research strength can be put in the treatment of the pathological mechanism of IPF for further exploration. The study was registered under registration number CRD42020193626.

Clinical Evaluation of the Effect of Daio (Rhei Rhizoma) on the Progression of Diabetic Nephropathy with Overt Proteinuria

2003 ◽  
Vol 31 (02) ◽  
pp. 267-275 ◽  
Author(s):  
Hirozo Goto ◽  
Yutaka Shimada ◽  
Kiyoaki Tanikawa ◽  
Shigehiko Sato ◽  
Hiroaki Hikiami ◽  
...  
Keyword(s):  
Diabetic Nephropathy ◽  
Serum Creatinine ◽  
Serum Creatinine Level ◽  
Creatinine Level ◽  
Herbal Medicines ◽  
Control Group ◽  
Dialysis Treatment ◽  
Rhei Rhizoma ◽  
The Mean ◽  
Overt Proteinuria

We studied the effect of traditional herbal medicines containing Daio (Rhei Rhizoma) on the long-term progression of diabetic nephropathy with overt proteinuria in eight patients [mean age 60 (45–73) years; duration of diabetes 18 (7–36) years]. At the beginning of the study, mean HbA1c was 8.2% and mean serum creatinine was 1.0 ± 0.3 mg/dl. Every patient had diabetic neuropathy and retinopathy. Three of the patients had hypertension and four had ischemic heart disease. After 107 ± 25 months, the mean serum creatinine level had significantly increased to 4.8 ± 2.6 mg/dl. The mean serum creatinine levels of five patients not advancing to dialysis treatment increased from 1.2 ± 0.3 to 3.2 ± 1.0 mg/dl, and the three patients requiring dialysis increased from 0.8 ± 0.1 to 7.5 ± 2.1 mg/dl. In the control group, treated without traditional herbal medicines, the mean serum creatinine level had significantly increased from 1.0 ± 0.3 to 9.5 ± 1.9 mg/dl after 71 ± 12 months. All of the control group required dialysis treatment. Diabetic nephropathy with overt proteinuria is reported to develop into renal failure after 6–7 years. In this retrospective study, traditional herbal medicines with Daio were considered to be effective in prolonging the pre-dialysis period of diabetic nephropathy.

scholarly journals Study of effectiveness of antiviral drugs (umifenovir, triazavirin) against acute respiratory viral infections

2018 ◽  
Vol 99 (2) ◽  
pp. 215-223 ◽  
Author(s):  
E P Tikhonova ◽  
T Yu Kuz'mina ◽  
N V Andronova ◽  
O A Tyushevskaya ◽  
T A Elistratova ◽  
...  
Keyword(s):  
Antiviral Therapy ◽  
Clinical Efficacy ◽  
Viral Infections ◽  
Clinical Symptoms ◽  
Antiviral Drug ◽  
Antiviral Drugs ◽  
Control Group ◽  
Efficacy And Safety ◽  
Respiratory Viral Infections ◽  
Adaptive Reactions

Aim. Comparative study of clinical efficacy and safety of antiviral drug triazavirin and umifenovir in the treatment of patients with acute respiratory viral infections and influenza. Methods. The study included 100 patients aged 18 to 65 years diagnosed with moderate acute respiratory viral infection. Group 1 included 34 patients receiving umifenovir 200 mg 4 times a day for 5 days, and comparison group included 32 patients who received triazavirin 1 capsule (250 mg) 3 times a day for 5 days. Group 3 (control group) included 34 patients not treated with antiviral therapy. Efficacy and safety of the studied antiviral drugs were evaluated based on clinical symptoms in the disease course and were confirmed by adaptive reactions of the organism. Results. Among patients receiving triazavirin, recovery time and fever, headache and catarrhal syndrome resolution time were less than among patients who received umifenovir. On triazavirin treatment with favorable tolerability, symptomatic medications (antipyretics) were discontinued, and the duration of their use was less, than in patients receiving umifenovir. Evaluation of clinical efficacy of umifenovir and triazavirin for the treatment of acute respiratory viral infections and influenza demonstrated that the drugs effectively reverse the main symptoms of the disease (p <0.05), reduce complications incidence (18.1±2.1% vs. 55.9±3.2%, p <0.05) and contribute to the stabilization of adaptive reactions of the organism in contrast to the results of patients not receiving etiotropic therapy (6.9±2.9% vs. 12.8±2.7, p <0.05). During the use of umifenovir by day 4 and during the use of triazavirin by day 3 intoxication and catarrhal syndromes had been reversed, while in case of the absence of antiviral therapy, 55.8% of patients had continuing intoxication and catarrhal symptoms. Conclusion. The results of the study allow defining umifenovir and triazavirin as the first line of defense against acute respiratory viral infections with good efficacy and tolerability of the drugs.

scholarly journals The Efficacy of Tripterygium Glycosides Combined with LMWH in Treatment of HSPN in Children

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Yan Jin ◽  
Yanzheng Wang ◽  
Sai Wang ◽  
Qiongqiong Zhao ◽  
Donghua Zhang ◽  
...  
Keyword(s):  
Clinical Efficacy ◽  
Clinical Symptoms ◽  
Effective Rate ◽  
Control Group ◽  
Clinical Effects ◽  
Observation Group ◽  
Significant Difference ◽  
Before And After ◽  
Qilu Hospital ◽  
Tripterygium Glycosides

Objective. This study aimed to explore the clinical efficacy and relevant mechanism of Tripterygium glycosides combined with low molecular weight heparin calcium (LMWH) in the treatment of Henoch–Schönlein purpura nephritis (HSPN) in children. Methods. 64 cases of children patients with HSPN treated at Qilu Hospital (Qingdao) from January 2015 to May 2020 were selected and randomly divided into the control group and the observation group and 32 cases in each group. Conventional medical treatment was applied in the two groups, besides which the control group was given LMWH while the observation group was given Tripterygium glycosides based on the control group. The clinical efficacy and the indexes of clinical symptoms of the two groups were compared. Immune globulin level, fibrinogen content (FIB), prothrombin time (PT), platelet level (PLT), and activated partial thromboplastin time (APTT) level of the two groups were compared before and after the treatment. Results. The total effective rate in the observation group was significantly higher than that of the control group, and the recurrence rate in the observation group was lower than that in the control group. After treatment, urine red blood cell count and 24 h urine protein were obviously better than those of the control group. There was no statistically significant difference in PT between the two groups of children before and after treatment. The levels of PLT and FIB in the two groups of patients after treatment were significantly lower than before treatment, and the PLT levels in the observation group were lower than those in the control group. Conclusion. The combination of Tripterygium glycosides and LMWH had good clinical effects in the treatment of children with HSPN, and it could improve the clinical symptoms, the mechanism of which might be related to the increase of PT, a decrease of PLT, and the improvement of coagulation function.

scholarly journals DIABETIC NEPHROPATHY

2018 ◽  
Vol 25 (07) ◽  
pp. 1117-1123
Author(s):  
Faiza Irshad ◽  
Rabia Sajjad Toor ◽  
Madiha Hussain
Keyword(s):  
Body Weight ◽  
Diabetic Nephropathy ◽  
Serum Creatinine ◽  
Aqueous Extract ◽  
Antioxidant Properties ◽  
Control Group ◽  
Albino Rats ◽  
P Value ◽  
Kidney Weight ◽  
Experimental Group

Background: Zingiber Officinale Roscoe (Zingiberaceae family) is knownas Ginger. It is famous for its antioxidant properties. Objectives: To evaluate the effects ofGinger aqueous extract on the serum creatinine and paired kidney weight in Alloxan induceddiabetic nephropathy of albino rats. Study Design: Experimental study. Period: 06 months01-01-2013 to 30 June 2013. Setting: Anatomy Department, Sheikh Zayed, PGMI Lahore.Materials and Methods: Diabetes mellitus was induced with Alloxan intraperitoneally (150 mg/kg body weight) in Experimental groups B & C. Then the rats of experimental group C received200mg/kg body weight of ginger aqueous extract by gavage daily for five weeks starting from8th day after Alloxan injection. Results: Serum creatinine levels increased more in experimentalgroup B as compared to experimental group C. Group wise comparison of creatinine levelrevealed that the difference among control (A group) and experimental (B & C Groups) wassignificant having p-value <0.001. We observed that Paired kidney weight in experimentalgroup B increased as compared to control group A. Less increase in the paired kidney weightwas observed in experimental group C as compared to experimental group B. The differenceof mean paired kidney weight among three groups was significant having p-value <0.001.Conclusion: The results of the present study indicated that the co-treatment of Ginger aqueousextract prevented alloxan induced diabetic nephropathy in albino rats. The aqueous extract ofGinger showed amazing results on paired kidney weight.

scholarly journals Evaluation of the clinical efficacy and safety of nitric oxide synthesized from room air in the postoperative period of cardiac surgery

2021 ◽  
Vol 8 (1) ◽  
pp. 38-50
Author(s):  
A. E. Bautin ◽  
V. D. Selemir ◽  
A. I. Shafikova ◽  
K. Yu. Afanasyeva ◽  
E. S. Kurskova ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Cardiac Surgery ◽  
Side Effects ◽  
Pulmonary Artery ◽  
Clinical Efficacy ◽  
Median Duration ◽  
Postoperative Period ◽  
Main Group ◽  
Control Group ◽  
Efficacy And Safety

Background. Inhaled nitric oxide is a highly selective pulmonary vasodilator, the potential benefits of which include reduced resistance and pressure in the pulmonary artery without systemic arterial hypotension, vasodilation in well-ventilated areas of the lungs, rapid onset of action, and a fairly low incidence of side effects in the therapeutic dose range. Objective. Тс estimate the clinical efficacy and safety of the method for synthesizing nitric oxide from room air in the postoperative period of cardiac surgery. Design and methods. A total of 110 patients were enrolled in the study: 55 patients were included in the main group (nitric oxide was synthesized from room air by AIT-NO-01 device), 55 patients were enrolled in the retrospective control group (nitric oxide was inhaled from the balloon). Inclusion criteria were: undergone heart surgery, mean pulmonary artery pressure (PAPm) ≥ 25 mm Hg., pulmonary artery wedge pressure (PAWP) ≤ 15 mm Hg. Results. After one hour of nitric oxide inhalation in the main group, there were a 35 % decrease in PVR and a 16 % decrease in PAPm. In the control group, there were a decrease in PVR by 40 % and decrease in PAPm by 19 %. Inhalation of nitric oxide did not affect the systemic circulation hemodynamics both in the main and in the control groups. The median duration of the mechanical ventilation (MV) was 7.3 (4.5; 13.8) h and the median length of stay (LOS) in the ICU was 23.2 (21.3; 46) h in the main group. In the retrospective control group, the median duration of MV was 8.2 (5; 14.1) h, and the length of ICU stay was 24 (22; 45.3) h; found no differences between the groups. Conclusion. Nitric oxide synthesized from room air significantly reduces PVR and PAPm in patients with precapillary pulmonary hypertension after cardiac surgery. There were no significant differences in the effect on a pulmonary circulation, clinical data and side effects between the methods of synthesis of nitric oxide from room air and dosing from balloons.

scholarly journals ANGPTL4: A Predictive Marker for Diabetic Nephropathy

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Eman Al Shawaf ◽  
Mohamed Abu-Farha ◽  
Sriraman Devarajan ◽  
Zahra Alsairafi ◽  
Irina Al-Khairi ◽  
...  
Keyword(s):  
Diabetic Nephropathy ◽  
Serum Creatinine ◽  
Diabetic Kidney Disease ◽  
Potential Role ◽  
Biochemical Marker ◽  
Predictive Marker ◽  
Control Group ◽  
Clinical Markers ◽  
Associated Proteins

Background. ANGPTL4 is a glycoprotein that is involved in regulating triglyceride metabolism by inhibiting LPL activity under fasting conditions. Additionally, ANGPTL4 has been suggested as a link between hypertriglyceridemia and albuminuria in the nephrotic syndrome. In this study, we examined levels of circulating ANGPTL4 in people with diabetic nephropathy (DN) and its association with established DN-associated proteins such as IGFBP1 and IGFBP4. Methods. We quantified circulating ANGPTL4, IGFBP1, IGFBP3, and IGFBP4 in fasting plasma samples of 122 Kuwaiti participants using a multiplexing assay. The study involved 36 controls, as well as 86 people with type 2 diabetes (T2D) including 37 people with normal kidney function and 49 people with DN. Results. ANGPTL4 level was increased in people with DN (241.56±14.1 μg/ml) compared to the control group (178.43±24.09 μg/ml). The increase in ANGPTL4 correlated with clinical parameters of DN including albumin-to-creatinine ratio (r=0.271, P=0.002), serum creatinine (r=0.381, P=0.0001), and eGFR (r=−0.349, P<0.0001). Furthermore, ANGPTL4 correlated positively with both IGFBP1 (r=0.202, P=0.026) and IGFBP4 (r=0.364, P<0.0001). Multiple regression analysis showed increased IGFBP1 and TG as predictors of higher ANGPTL4 in people with DN. In people with T2D, only IGFBP1 acted as a positive predictor of a rise in ANGPTL4. Conclusion. In this study, our data showed a significant increase in circulating ANGPTL4, IGFBP1, and IGFBP4 in patients with DN. The elevation in ANGPTL4 correlated significantly with clinical markers of DN such as ACR, serum creatinine, and eGFR, as well as IGFBP1 and IGFBP4. Altogether, this suggests a potential role for ANGPTL4 in DN perhaps through its role in inhibiting LPL activity and promotes ANGPTL4 as a biochemical marker for the detection of a diabetic kidney disease in patients with T2D.

scholarly journals Effect of Diclofenac Sodium in Broilers

2015 ◽  
Vol 13 (1) ◽  
pp. 19-24
Author(s):  
R Akter ◽  
MAW Sarker
Keyword(s):  
Body Weight ◽  
Serum Creatinine ◽  
Diclofenac Sodium ◽  
Post Treatment ◽  
Control Group ◽  
High Dose ◽  
Broiler Chicks ◽  
Serum Urea ◽  
Group A ◽  
Group B

This study was conducted to determine the effects of diclofenac sodium in broiler chicks during the period from 20th July /2012 to 1st september/2012. The broiler chicks were divided into four groups A, B, C and control with ten day old bird in each. Group A was treated with @ 5mg/kg body weight, group B was treated with @ 10mg/kg body weight and Group C was treated with 20 mg/kg body weight given orally mixing with drinking water. Histopathological, hematological and biochemical tests were performed on 42th days of age to evaluate diclofenac-induced changes between control and treated groups. Mortality rate and pathomorphological changes were observed in dead birds. The acute toxicity was assessed by observing the clinical signs and symptoms, mortality, alterations in blood biochemistry, and necropsy findings. The birds of Group A showed only mild symptoms of diarrhea and 30% mortality. In Group B, 60% and Group 70% of birds died in between 24 and 36 h post-treatment showing the symptoms of segregatory behavior, lethargy, terminal anorexia, and severe bloody diarrhea. Observation of hematological parameters like TEC, Hb, PCV and ESR on 42th days of age showed significant (p<0.01) decrease in treatment group compare to control group. Observation of biochemical parameters (serum urea, serum creatinine) on 42th days of age showed significantly increased (p<0.01) serum urea and serum creatinine indicating nephrotoxicity in broilers. At 12 and 24 h post-treatment this returned to the normal levels. The dead birds of the high-dose group also showed similar pattern of biochemical changes at 12 and 24 h post-treatment and revealed extensive visceral gout with characteristic histopathological lesions in liver, kidney, heart, spleen and intestine on post-mortem. The results indicate that diclofenac sodium has hepatotoxic, nephrotoxic, and visceral gout inducing potentials in broilers (cob-500), especially at higher dose.DOI: http://dx.doi.org/10.3329/bjvm.v13i1.23710Bangl. J. Vet. Med. (2015). 13 (1): 19-24

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