Global Research Trends in Traditional Chinese Medicine for Diabetic Kidney Disease: A 20-Year Bibliometric Analysis.

Abstract

The global burden of diabetic kidney disease (DKD) continues to escalate, establishing it as a predominant contributor to chronic kidney failure; nonetheless, effective therapeutic options remain limited. Emerging evidence indicates that traditional chinese medicine (TCM) may offer novel strategies for addressing this condition. However, the existing literature is characterized by considerable heterogeneity in both the specific TCM interventions employed (eg, single herbs, compound formulas, and phytochemical extracts) and the reported therapeutic outcomes across individual studies, and previous reviews have been constrained by a narrow focus on specific herbal preparations or single-outcome measures, lacking a systematic overview of the entire research landscape. Consequently, to obtain a holistic understanding of TCM research in DKD, this study applied bibliometric methods to systematically map the current status, research breadth, and evolving trends within this domain. A bibliometric analysis was conducted on 1249 publications retrieved from the Web of Science Core Collection, spanning two decades (2004-2024). To ensure comprehensive coverage, the search strategy broadly defined TCM research to include single herbs, compound formulas, phytochemical constituents, network pharmacology approaches, clinical observational studies, and experimental mechanistic investigations. Data were analyzed using CiteSpace and VOSviewer to visualize publication trajectories, author/institutional collaborations, keyword clusters, and research hotspots. Focus areas included thematic shifts, methodological advancements, and clinical translation challenges. A systematic literature search yielded 1249 eligible publications. Over the two-decade study period, annual publication output demonstrated substantial growth, peaking in 2022. Geographically, primary research contributions originated from East Asian nations, particularly China, alongside the United States. Quantitative analyses identified the top 10 most productive authors, leading journals, and highly cited articles; additionally, 16 distinct citation clusters were delineated, and keyword evolution was tracked across seven thematic categories. Notably, 2022 witnessed marked increases in knowledge base expansion, collaborative intensity, and publication productivity. The field exhibits pronounced interdisciplinary characteristics, with network pharmacology emerging as a dominant paradigm in contemporary TCM research. Burst detection analysis further revealed that the integration of TCM and DKD research converges on two principal biological processes: inflammatory pathways and oxidative stress mechanisms. This study represents the first systematic, quantitative, and visual documentation of the evolutionary trajectory of TCM applications in DKD treatment, revealing substantial acceleration in recent years. These findings underscore the pivotal importance of interdisciplinary collaboration and the imperative for strengthened global research partnerships. Leveraging technological advances in the big data era, network pharmacology provides a holistic, systems-based paradigm that offers innovative pathways for investigating TCM and its mechanisms of action. Three ethnomedicinal species-<i>Astragalus mongholicus</i> Bunge, <i>Salvia miltiorrhiza</i> Bunge, and <i>Cornus officinalis</i> Siebold &amp; Zucc.-demonstrate potential as sources of bioactive compounds for DKD therapy, supported by extensive historical clinical application.