Chinese herbal medicine may be effective and safe for treating diabetic kidney disease, although evidence quality varies.
The systematic review and meta-analysis comprised randomized controlled trials comparing the use of oral Chinese herbal medicine (CHM) to a placebo, involving a comprehensive search strategy and selecting from over 7000 articles, resulting in 20 studies with a total of 2719 participants. Potential bias was minimized by only including studies that pitted CHM against a placebo. In addition, an a priori subgroups analysis was conducted to identify potential candidate formulae and frequently used herbs for further exploration.
Despite these measures, the overall evidence ranged from moderate to very low quality due to unclear randomization procedures, substantial variations in outcome measures, and reduced external validity. The latter was affected by factors such as multi-ingredient herbal formulae, brief follow-up periods, limited numbers of clinical events, and the inclusion of older patients with less advanced disease.
