Abelmoschus manihot for Diabetic Nephropathy: A Systematic Review and Meta-Analysis

Table 1

Characteristics of 72 included studies on Abelmoschus manihot for diabetic nephropathy.

Included studies	No. of patients	Mean age, y	Male, %	Baseline 24h UP (g/d)	Intervention		Duration (weeks)	Outcome measures
					Treatment group	Control group
Chang LL2009[27]	128	47.2	61	3.7	Benazepril 10 mg/d; + HK 3.0 g tid	Benazepril 10 mg/d	4	A
Chen XB 2014[28]	150	58.4	51	2.4	Benazepril 10 mg/d; + HK 2.5 g tid	Benazepril 10 mg/d	8	AFG
Cheng Y 2016[29]	90	58.8	52	NA	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	8	CEFG
Dai X 2017[30]	80	46.7	46	NA	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	12	CFG
Deng SY 2014[31]	60	43.8	50	NA	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	16	CFG
Du Y 2015[32]	73	59.4	45	1.0	ACEI/ARB; + HK 2.5 g tid	ACEI/ARB	12	ADFG
Fan HW 2014[33]	52	49.1	48	NA	Candesartan 4 mg/d; + HK 2.5 g tid	Candesartan 4 mg/d +placebo 2.5 g tid	24	CF
Gao Q 2017[34]	80	53.7	68	3.3	Irbesartan 150 mg/d; + HK 2.5 g tid	Irbesartan 150 mg/d	16	ABCFG
Gu J 2015[35]	200	68.3	55	1.8	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	8	ACDFG
Guan ZX 2008[36]	80	45.5	54	1.4	ACEI; + HK 2.5 g tid	ACEI	8	AG
Guo G 2015[37]	136	42.8	53	0.3	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	8	ABCFG
He YN 2010[38]	80	44.4	54	NA	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	12	EFG
Hu JP 2011[39]	80	NA	NA	1.5	Telmisartan 80 mg/d; + HK 2.5 g tid	Telmisartan 80 mg/d	8	AFG
Hu YY 2016[40]	40	56.9	60	0.1	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	8	ADFG
Huang XM 2016[41]	82	43.4	57	0.4	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	16	ABCF
Jia ZW 2015[42]	70	51.4	64	2.7	Candesartan 4 mg/d; + HK 2.0 g tid	Candesartan 4 mg/d	4	AFG
Jiang ZJ 2012[43]	66	50.7	64	2.2	ACEI/ARB; + HK 2.5 g tid	ACEI/ARB	16	AFD
Li HY 2009[44]	80	52.1	50	1.2	Fosinopril 10 mg/d; + HK 2.5 g tid	Fosinopril 10 mg/d	8	AFG
Li QH 2010[45]	72	52.5	63	NA	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	8	CG
Li WQ 2015[46]	72	48.3	57	0.3	Irbesartan 150 mg/d; + HK 2.5 g tid	Irbesartan 150 mg/d	12	ACF
Li XM 2017[47]	62	60.9	54	NA	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	8	CEG
Li YH 2016[48]	65	49.3	53	0.9	Benazepril 10 mg/d; + HK 2.0 g tid	Benazepril 10 mg/d	16	ACFG
Li YL 2007[49]	60	41.5	54	1.5	Benazepril 10 mg/d; + HK 2.5 g tid	Benazepril 10 mg/d	8	AFG
Li YL 2017[50]	86	59.2	52	NA	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	8	CEG
Li YT 2014[51]	95	48.4	63	NA	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	6	CFG
Li ZY 2014[52]	126	57.4	NA	0.4	ACEI/ARB; + HK 2.5 g tid	ACEI/ARB	24	ACF
Liang F 2015[53]	100	44.8	54	NA	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	6	CFG
Liang YP 2014[54]	50	43.2	47	NA	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	8	CG
Liao YY 2017[55]	92	58.5	57	NA	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	8	CG
Liu AY 2014[56]	100	60.5	43	2.4	Losartan Potassium 50 mg/d+HK 2.5 g tid	Losartan Potassium 50 mg/d	12	AFG
Liu H 2010[57]	80		54	6.2	Irbesartan; + HK 2.5 g tid	Irbesartan	8	A
Liu JF 2011[58]	48		67	2.4	Candesartan; + HK 2.5 g tid	Candesartan	12	AF
Lu C 2015[59]	80	42.1	54	NA	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	8	CG
Luan R 2012[60]	96	42.3	59	3.8	ACEI/ARB; + HK 2.5 g tid	ACEI/ARB	12	AFG
Ma F 2016[61]	80	49.1	54	NA	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	6	CFG
Meng Y 2017[62]	86	45.9	56	NA	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	8	CEG
Pan Q 2016[63]	96	64.6	65	0.7	Benazepril 10 mg/d or Valsartan 80 mg/d+ HK 2.5 g tid	Benazepril 10 mg/d or Valsartan 80 mg/d	8	ACFG
Qi MG 2016[64]	84	60.9	51	0.2	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	12	AF
Qian C 2014[65]	120	51.0	53	2.4	Irbesartan 150 mg/d; + HK 2.0 g tid	Irbesartan 150 mg/d	16	A
Qian CF 2010[66]	59	51.1	51	NA	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	16	C
Qian JL 2013[67]	70	47.6	69	NA	Candesartan 4 mg/d; + HK 2.5 g tid	Candesartan 4 mg/d	24	CFG
Qiao B 2015[68]	60	52.8	33	NA	Benazepril 10 mg/d; + HK 2.5 g tid	Benazepril 10 mg/d	12	CFG
Qiao Y 2015[69]	82	56.9	63	2.4	Enalapril 10 mg/d; + HK 2.5 g tid	Enalapril 10 mg/d	8	ADF
Qu XS 2013[70]	56	45.3	55	NA	Candesartan 4 mg/d; + HK 2.5 g tid	Candesartan 4 mg/d	24	CFG
Rao WP 2016[71]	58	42.1	60	4.4	Benazepril 10 mg/d; + HK 2.5 g tid	Benazepril 10 mg/d	8	AFG
Shen LL 2010[72]	82	42.3	61	NA	ACEI/ARB; + HK 2.5 g tid	ACEI/ARB	12	FG
Song XL 2012[73]	60	40.7	NA	4.6	Benazepril; + HK 2.5 g tid	Benazepril	12	AFG
Su JP 2009[74]	65	54.2	55	1.0	ACEI/ARB; + HK 2.5 g tid	ACEI/ARB	24	ABCDEFG
Sun XM 2012[75]	90	62.3	63	3.7	Benazepril 10 mg/d; + HK 2.5 g tid	Benazepril 10 mg/d	12	ADFG
Wang XC 2010[76]	63	59.2	51	0.4	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	16	ACF
Wu RK 2017[77]	50	53.7	65	NA	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	6	CEFG
Wu YH 2016[78]	48	56.1	54	1.5	Irbesartan 150-300 mg/d + HK 2.5 g tid	Irbesartan150-300 mg/d	16	AFG
Xiao ZZ 2010[79]	65	58.3	52	0.3	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	16	ABCF
Xu GH 2014[80]	80	58.3	52	2.7	Telmisartan 80 mg/d; + HK 2.5 g tid	Telmisartan 80 mg/d	12	ADFG
Xu RF 2012[81]	90	58.0	64	NA	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	8	F
Xu SS 2016[82]	124	43.5	54	NA	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	24	CF
Xu WM 2013[83]	61	36.0	56	NA	Irbesartan 150 mg/d; + HK 2.5 g tid	Irbesartan 150 mg/d	4	CFG
Yan QJ 2015[84]	120	65.9	66	NA	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	8	ACDF
Yan XP 2017[85]	70	52.9	47	NA	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	10	EG
Yu JY 1995[86]	68	54.6	65	0.9	Captopril+Abelmoschus alcohol extraction 0.4 g tid	Captopril	8	ADFG
Yu ZW 2011[87]	58	69.0	45	1.5	Candesartan 8 mg/d; + HK 2.5 g tid	Candesartan 8 mg/d	24	AFG
Zeng Y 2013[88]	50	67.6	54	2.3	Losartan 50 mg/d; + HK 2.5 g tid	Losartan 50 mg/d	12	AF
Zhang H 2011[89]	58	58.2	55	1.7	Valsartan 80-160 mg/d; + HK 2.5 g tid	Valsartan 80-160 mg/d	8	ACDEF
Zhang JW 2017[90]	112	53.0	48	NA	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	16	CG
Zhang RX 2016[91]	80	51.3	53	NA	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	8	CG
Zhang YS 2014[92]	110	50.0	56	3.4	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	16	ABCFG
Zhang ZY 2017[93]	80	64.1	54	1.9	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	8	ABFG
Zhao DH 2017[94]	80	50.8	54	NA	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	6	CEFG
Zhao Y 2015[95]	92	49.2	55	NA	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	8	CFG
Zhou BX 2008[96]	97	NA	NA	0.97	Benazepril 10 mg/d; + HK 2.5 g tid	Benazepril 10 mg/d	8	ACG
Zhou XJ 2016[97]	96	66.1	59	NA	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	8	CFG
Zhu JL 2017[98]	84	59.8	58	NA	Valsartan 80 mg/d; + HK 2.5 g tid	Valsartan 80 mg/d	8	CEFG

Notes: HK: Huangkui Capsule, a single medicament of TCM extracted from the dry corolla of Abelmoschus manihot, acquired regulatory approval from China's State Food and Drug Administration (SFDA) for the treatment of chronic nephritis in 1999; ACEI: angiotensin-converting enzyme inhibitor; ARB: angiotensin receptor blocker; NA: not available; : age range was reported, but mean age was not available; A: 24 h UP, 24-h urinary protein; B: eGFR: Estimated glomerular filtration rate; C: UAER, urinary albumin excretion rate; D: 24-h urinary protein (24 h UP) reduction rate, defined as the proportion of 24h UP decrease in protein excretion ≥50% of the baseline at the end of the study; E: normalization of urinary albumin excretion rate (UAER), defined as the proportion of UAER <20 μg/min upon study completion; F: SCr, serum creatinine; G: ADEs, adverse drug events.