Zhenwu Decoction

Objective. To perform a systematic evaluation of the clinical efficacy and safety of Zhenwu decoction (ZWD) for the treatment of diabetic nephropathy (DN). Methods. PubMed, the China National Knowledge Infrastructure (CNKI), the China Science and Technology Journal Database (VIP), the Chinese Biomedical Literature Database (CBM), and the WanFang databases were searched, and a systematic review and meta-analysis of randomized controlled trials (RCTs) were subsequently conducted to compare the efficacy and safety of ZWD combined with conventional Western medicine (CWM) to conventional therapy alone in the treatment of DN. The Cochrane Handbook for Systematic Reviews of Interventions and GRADE criteria were utilized to assess the quality of the included literature, and RevMan 5.3 software was used for statistical analysis. Results. 13 randomized controlled trials were included, involving 1347 patients with diabetic nephropathy assigned into two subgroups according to the disease duration. The results revealed that compared with conventional therapy alone, ZWD combined with CWM treatment significantly improved the total effective rate (OR = 3.88, 95% CI = (2.87, 5.26), $P$ < 0.00001). Furthermore, ZWD combination therapy also decreased fasting blood glucose (MD = −0.72, 95% CI = (−0.97, −0.48), $P$ < 0.00001), BUN (MD = −1.92, 95% CI = (−3.19, −0.64), $P$ = 0.003), 24-hour urine protein (MD = −0.48, 95% CI = (−0.57, −0.39), $P$ < 0.00001), and serum creatinine levels (MD = −51.17, 95% CI = (−66.95, −35.39), $P$ < 0.00001). However,there was no statistical significance in the effect of combination therapy on creatinine clearance (MD = −0.64, 95% CI = [−8.21,6.92], P = 0.87). However, there was no statistical significance in the effect of combination therapy oncreatinine clearance (MD =−0.64, 95% CI=[−8.21,6.92], P=0.87). Conclusion. ZWD combined with CWM outperformed conventional Western medicine in DN treatment. However, further investigations via multicenter RCTs with rigorous designs and higher quality are still warranted.

Heart failure with reduced ejection fraction (HFrEF) demonstrates a substanital threat to global public health. Several Chinese studies have been conducted to date evaluating the clinical efficacy of Zhenwu decoction (ZWD) as a treatment for HFrEF. The present systematic review will be conducted to more comprehensively evaluate the impact of ZWD on HFrEF outcomes.

For this systematic review, all randomized controlled trials (RCTs) reporting on the effectiveness of ZWD as a treatment for HFrEF published as of December 30, 2021 in the Embase, PubMed, Springer, Web of Science, Cochrane Library, China Biomedical Literature Database, China National Knowledge Infrastructure, and the Wan-Fang databases will be identified without any language or publication restrictions. Two researchers will independently choose investigations, extract information, and gauge research quality. Primary outcomes of interest will include all-cause mortality and HF-associated mortality. Secondary outcomes will include the incidence of adverse events, ultrasonic cardiographic indices (including left ventricular ejection fraction and left ventricular mass index), New York Heart Association grade, N-terminal pro-b-type natriuretic peptide, B-type natriuretic peptide, and 6-minute walking distance. RevMan v 5.3 will be used to conduct meta-analyses where possible, with descriptive or subgroup analyses otherwise being conducted. Data will be given as risk ratios for categorical variables and mean difference for continuous variables.

This comprehensive protocol will aid in the systematic and objective evaluation of the efficacy and safety of ZWD as a treatment for HFrEF, providing a scientific basis for the clinical utilization of ZWD.