Astragalus Membranaceus Herbal Formula for the Treatment of Idiopathic Membranous Nephropathy with Nephrotic Syndrome: A Systematic Review and Meta-Analysis

The consequence of our meta-analysis shown that there was no significantly statistical difference in affecting total remission rate (RR: 1.02, 95% CI: 0.87 to 1.20, I2= 76%), levels of 24-hour urine protein excretion (24hUP) (MD: -0.50, 95% CI: -1.10 to 0.10, I2= 78%) and serum albumin (Alb) (MD: 0.45, 95% CI: -1.01 to 1.91, I2= 0%) between Astragalus membranaceus (AM) herbal formula and routine treatment (RT). However, AM herbal formula plus RT had more advantages in reducing total recurrence rate (RR = 0.33, 95% CI:0.18 to 0.61, I2= 0%), levels of 24hUP (MD: -0.77, 95% CI: -0.93 to -0.60, I2= 0%), total cholesterol (TC) (MD: -0.79, 95% CI: -1.09 to -0.48, I2= 45%), triglyceride (TG) (MD: -0.26, 95% CI: -0.39 to -0.14, I2= 52%) and increasing total remission rate (RR: 1.30, 95% CI: 1.16 to 1.46, I2= 0%) and Alb (MD: 1.87, 95% CI: 1.01 to 2.72, I2= 0%) levels than RT alone. In addition, when compared with RT alone, AM herbal formula used alone or plus RT had no significantly statistical difference in changing levels of serum creatinine (Scr) (MD: -1.05, 95% CI: -3.73 to 1.62, I2= 0%), blood urea nitrogen (BUN) (MD: -0.11, 95% CI: -0.34 to 0.12, I2= 0%), alanine aminotransferase (ALT) (MD: 0.15, 95% CI: -0.73 to 1.04, I2= 0%), aspartate aminotransferase (AST) (MD: -0.43, 95% CI: -1.39 to 0.54, I2= 9%) and fasting blood glucose (Glu) (MD: 0.00, 95% CI: -0.11 to 0.12, I2= 0%). Last but not least, AM herbal formula used alone or plus RT had a lower rate of total adverse events (RR: 0.51, 95% CI: 0.37 to 0.68, I2= 0%) than RT alone.