冬虫夏草制剂治疗急性肾损伤的系统评价  

Cordyceps sinensis for acute kidney injury-a systematic review

作　　者：洪涛[1] 赵玲[1] 夏映萍[1] 李雪梅[1] 

机构地区：[1]成都市第六人民医院肾内科,四川成都610051

出　　处：《中国生化药物杂志》2015年第5期61-65,71,共6页Chinese Journal of Biochemical Pharmaceutics

摘　　要：目的评估冬虫夏草制剂治疗急性肾损伤的效果和潜在的副作用,为临床实践提供证据。方法用相关的检索词检索包括MEDLINE、EMBASE、CENTRAL的英文数据库和包括CNKI、CBM、万方、和维普的中文数据库以及会议论文集、硕博士论文等文献库。提取数据,采用Rev Man 5.0软件进行meta分析。结果本系统评价共纳入7个随机对照临床研究(共纳入601急性肾损伤患者)。所有研究方法学质量均较低。在试验组和对照组均应用常规治疗的基础上,比较了虫草制剂与空白对照在急性肾损伤患者中应用的临床效果。Meta分析结果显示虫草制剂可以显著改善患者的血肌酐水平,缩短少尿期,提高尿渗透压(P<0.05)。同时显示了改善生存率和减少需要肾脏替代治疗的有益趋势。结论在常规治疗的基础上,虫草制剂应用于急性肾损伤患者,可以改善肾小球及肾小管功能,促进肾小管功能恢复,从而改善临床治疗效果。未来的临床研究需要较长的观察期以确定长期效果,并且需要较大样本、方法学更为完善的临床试验提供更为有力的证据。Objective To evaluate the benefits and potential adverse effects of Cordyceps sinensis as an adjuvant immunosuppressive treatment in acute kidney injury.Methods English language database （ including MEDLINE, EMBASE and CENTRAL） in systematic review searched, using search terms relevant to this review.Chinese language databases （ including CNKI, CBM, WanFang and other resources） in systematic review also searched.It included all randomised controlled trials （ RCTs） and quasi-RCTs evaluating the benefits and potential side effects of Cordyceps sinensis for acute kidney injury, irrespective of blinding or publication language.An inclusion criterion was that immunosuppressive therapy baseline must be the same across arms in each study.Data were collected and analyzed by RevMan 5.0.Methodological risk of bias was assessed using the Cochrane risk of bias tool. Results This review included 7 RCTs （representing a total of 601 patients with acute kidney injury） that assessed the use of Cordyceps.Reporting of methods was incomplete in most studies.It conducted comparisons of Cordyceps versus no treatments on the base of same conventional treatment in both groups.Cordyceps for patients showed a favorable trends toward improving patient survival and reducing renal replace treatment, but the difference did not reach significance.However, Cordyceps significantly reduce the level of serum creatinine shorten the period of oliguria, and increase the osmotic pressure of urine.Conclusion On the base of same conventional treatment in both groups, compared with no treatment, Cordyceps significantly improves the functions of renal tubule and glomerulus.But long-term studies are needed to clarify any benefit-harm trade-off.Future studies also need to be appropriately sized and powered.

关 键 词：冬虫夏草 急性肾损伤 系统评价 

分 类 号：R692.5[医药卫生—泌尿科学]