[Evidence mapping analysis of clinical research on TCM for diabetic kidney disease in recent six years]

The study employed an evidence mapping approach to systematically review clinical research on TCM for diabetic kidney disease(DKD) over the past six years and evaluate the current state of evidence, aiming to provide a scientific basis and decision reference for current gaps and future research directions. A comprehensive literature search was conducted across databases including CNKI, Wanfang, VIP, SinoMed, PubMed, Web of Science, EMbase, and Cochrane Library, yielding 310 publications related to TCM treatment of DKD. These included 289 randomized controlled trials(RCTs), 13 systematic reviews/Meta-analyses, and 8 guidelines/expert consensus documents. The analysis revealed an overall upward trend in publication volume, with oral administration being the predominant intervention method. Treatment durations were typically from two to three months, and sample sizes mostly ranged between 50-100 patients. A total of 30 different TCM decoctions and 39 Chinese patent medicines were investigated, with Shenqi Dihuang Decoction and Yishen Huashi Granules being the most frequently studied. The primary TCM syndrome patterns identified were Qi and Yin deficiency and spleen-kidney deficiency. Outcome indicators predominantly focused on clinical response rates, blood glucose-related indicators, and renal function parameters, with a notable lack of long-term outcome assessments. Methodological quality evaluation indicated significant shortcomings in RCT, particularly in allocation concealment and blinding, resulting in an overall low quality of evidence. Similarly, the systematic reviews/Meta-analyses were rated as "very low". In contrast, the guidelines and expert consensus documents demonstrated relatively acceptable quality, but there was room for further improvement in rigor and clinical application. The findings underscore the need for future research to address these methodological deficiencies, particularly by improving trial design and leveraging TCM advantages, so as to provide a more reliable evidence base for clinical decision-making in DKD prevention and treatment.