结肠透析联合中药灌肠治疗慢性肾脏病的Meta分析  

Meta-analysis of Colonic Dialysis combined with Retention Enema with Traditional Chinese Medicine in the Treatment of Chronic Kidney Disease

作　　者：包能 于翔 陈笑 王锦[1] 孔薇[2] BAO Neng;YU Xiang;CHEN Xiao;WANG Jin;KONG Wei(Nanjing University of Chinese Medicine, Nanjing Jiangsu 210029, China;The Third Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing Jiangsu 210029, China)

机构地区：[1]南京中医药大学,江苏南京210029 [2]南京中医药大学第三附属医院,江苏南京210029

出　　处：《中医药导报》2018年第14期87-92,共6页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：南京市科技发展计划(医疗卫生与国际合作)(201503032)

摘　　要：目的:利用Meta分析研究结肠透析联合中药灌肠治疗慢性肾脏病(CKD)的临床疗效。方法:计算机检索CENTRAL、MEDLINE、EMbase、Pub Med、CBM、Wan Fang Data和CNKI建库至2017年1月有关结肠透析联合中药治疗CKD的随机对照试验,并手工检索相关期刊,追溯纳入研究的参考文献。由2位评价者根据纳入和排除标准独立选择文献、搜集资料后使用Cochrane Reviewer's Handbook 4.2.2中的方法进行文献质量评价,最后使用Revman5.3.3软件进行Meta分析。结果:共纳入12篇文献,Meta分析结果显示结肠透析联合中药灌肠在改善CKD患者的一般症状,降低患者血肌酐浓度、血尿素氮浓度,提高血红蛋白浓度等方面优于对照组(P<0.05),而对于内生肌酐清除率的改善方面,差异无统计学意义(P>0.05)。结论:现有证据提示,结肠透析联合中药灌肠较传统中药灌肠治疗能进一步改善患者一般症状并延缓CKD病程进展。但由于纳入研究的质量相对偏低,以上结论尚需日后开展更多高质量的相关研究加以验证。Objective： To analyze the clinical effect of colonic dialysis combined with herbal enema in treating chronic kidney disease by Meta-analysis. Methods： All randomized controlled trials （RCTs） of retention enema with traditional Chinese medicine in the treatment of chronic kidney disease were collected from CENTRAL, MEDLINE, EMbase, PubMed, WanFang Data, CNKI and CBM. Two reviewers independently screened the ＇included studies, extracted the data, assessed the quality, and cross-checked then. And then literature quality evaluation and data analysis were conducted using the method in Cochrane Reviewer＇s Handbook 4.2.2. Finally, the software named Revman 5.3.3 was applied to do the Meta-analysis. Results： A total of 12 literature was included. The results of Meta-analysis showed that the therapy of colonic dialysis combined with herbal enema can reduce serum creatinine and blood urine nitrogen levels and increase hemoglobin levels in CKD patients, compared with the control group （P〈0.05）. However, there was no statistic difference between the two groups in increasing creatinine clearance of CKD patients （P〉0.05）. Conclusion： Current evidence reveals that the therapy of colonic dialysis combined with herbal enema is more effective in further improving the general symptoms of CKD patients and delaying progression of CKD. Whereas, various limitations in this process brought about that the conclusion of this Meta-analysis may not be convincing enough because of the low-quality clinical trials methodology adopted, some small-sample studies and short-term treatment. Altogether, caution is advised to be taken to explain these results.

关 键 词：慢性肾脏病 结肠透析 中药灌肠 META分析 

分 类 号：R256.5[医药卫生—中医内科学]