中医药治疗糖尿病肾病疗效Meta分析  

Meta-analysis about TCM Therapy for Diabetic Nephropathy

作　　者：杜博[1] 刘永进[1] 黄苏萍[1] 邵江健 陈超云[2] 

机构地区：[1]福建中医药大学中西医结合研究院,福建福州350122 [2]福建中医药大学骨伤学院,福建福州350122

出　　处：《亚太传统医药》2017年第11期33-38,共6页Asia-Pacific Traditional Medicine

基　　金：福建省科技计划重点项目(2014Y0063)

摘　　要：目的:评价中医药治疗糖尿病肾病(DN)的疗效与安全性。方法:运用循证医学Cochrane系统评价方法,检索PubMed、CNKI、WanFang Data、VIP等数据库,以DN患者为研究对象,全面搜集并纳入国内外有关中医药治疗DN的随机对照试验(RCT),检索时限设定为2006年1月-2016年10月。由2位评价者独立筛选文献、提取资料和评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果:纳入10篇RCT,共974例患者。Meta分析显示:与对照组相比,中医药治疗组的临床疗效优于对照组[RR=1.71,P=0.000 1];中医药治疗组在降低DN患者尿微量蛋白排泄率[WMD=-48.70,P<0.000 01]、肌酐[WMD=-0.69,P<0.000 01]、尿素氮[WMD=-0.93,P=0.04<0.05]、空腹血糖[WMD=-1.08,P=0.004]、胆固醇[WMD=-1.01,P<0.000 01]和甘油三酯[WMD=-0.75,P<0.000 01]等方面存在优势;但在降低餐后2h血糖[WMD=-1.34,P=0.20>0.05]和糖化血红蛋白[WMD=-0.46,P=0.05]方面差异无统计学意义。结论:中医药治疗可在一定程度上改善DN患者的肾功能,降低血糖和血脂水平;且不良反应较少,临床使用相对安全可靠。Objective： To systematically review the efficacy and safety of traditional Chinese medicine（TCM）therapy in the treat- ment of diabetic nephropathy（DN）. Methods：We electronically searched databases including PubMed, CNKI, WanFang Data and VIP databases to collect randomized controlled trials （RCTs）about TCM therapy for DN from January 2006 to October 2016. Two reviewers indpendently screened literature, extracted data and assessed the risk of bias of included RCTs. Then, meta--analysis was performed by using RevMan 5.3 software. Results：A total of 10 RCTs involving 974 patients were included. The results of meta-analysis showed that, TCM therapy had advantage over conventional therapy. The clinical efficiency of TCM therapy group is better than the control group[RR=1. 71, P=0. 0001];Compared with the control group, the levels of UAER[WMD=-48.70, P〈0. 000013,SCr[WMD=-0. 69,P〈0. 00001], BUN[WMD=-0.93,P=0.04〈0. 053, TC[WMD=1. 01, P〈0. 00001],TG[WMD=-0.75,P〈0. 000013 in TCM therapy group were significantly decreased;However,the levels of 2hPG[WMD= 1.34,P =0. 20〉0. 053 and HbAlc[WMD： 0.46, P=0. 053had no statistical significance between these two groups. Conclusion：Current evidences indicates that TCM therapy is effective and safe in the treatment of DN.

关 键 词：糖尿病肾病 中医药 系统评价 META分析 随机对照试验 

分 类 号：R255.4[医药卫生—中医内科学]