针刺辅助治疗糖尿病肾脏病的Meta分析  

Meta-analysis of acupuncture as an adjuvant treatment for diabetic kidney disease

作　　者：赵庆 孙鲁英 郑启艳 张笑笑 金化男 陈美玲 姚志 Zhao Qing;Sun Luying;Zheng Qiyan;Zhang Xiaoxiao;Jin Huanan;Chen Meiling;Yao Zhi(Dongzhimen Hospital,Beijing University of Cohinese Medicine,Beijing 100700;Sun Simiao Hospital,Beijing University of Chinese Medicine)

机构地区：[1]北京中医药大学东直门医院,北京100700 [2]北京中医药大学孙思邈医院

出　　处：《现代中医临床》2020年第3期41-48,共8页Modern Chinese Clinical Medicine

基　　金：国家科技支撑计划项目(No.2011BAI10B00)。

摘　　要：目的系统评价针刺辅助治疗糖尿病肾脏病(DKD)的临床疗效。方法计算机检索PubMed、EMbase、Cochrane Library、CBM、CNKI、WanFang和VIP数据库等,由2位研究者分别筛选文献、提取资料,对文献进行质量评价。用RevMan 5.3软件作meta分析。结果纳入8篇RCT,共491例DKD患者。Meta分析结果:①5个研究比较针刺组与对照组对DKD患者尿白蛋白排泄率(UAE)的影响:SMD=-2.49,95%CI -4.11 to 0.86,P=0.003;I^2=97%;②5个研究比较针刺组与对照组对DKD患者血肌酐(Scr)的影响:MD=-15.44,95%CI -26.55 to -4.33,P=0.006;I^2=90%;③4个研究比较针刺组与对照组对DKD患者血尿素氮(BUN)的影响:MD=-1.83,95%CI -2.97 to -0.70,P=0.002;I^2=93%;④4个研究比较针刺组与对照组对DKD患者TG的影响:MD=-0.69,95%CI -1.23 to -0.15,P=0.01;I^2=87%;⑤7个研究比较针刺组与对照组对DKD患者临床总有效率的影响:OR=3.89,95%CI 2.18 to 6.93,P<0.00001;I^2=0%。结论针刺辅助治疗DKD能显著降低UAE和血脂,改善肾功能,提高DKD治疗临床有效率;同时当重视肾俞、关元、足三里、太溪等穴位的选用。Objective To make a systematic evaluation of clinical efficacy of acupuncture as an adjuvant treatment for diabetic nephropathy.Methods Databases including PubMed,EMbase,BMJ,CNKI,Wang fang and VIP were searched.Two researchers independently screened the literature and extracted the data,and then evaluated the quality of the literature,and last performed a meta-analysis using RevMan 5.3.Results A total of 8 trials involving 491 patients were included.Compared with the single treatment group just as the Western medicine or the traditional Chinese medicine,acupuncture treatment reduced UAE[SMD=-2.49,95%CI -4.11 to 0.86,P=0.003;I^2=97%;5 trials],Scr[MD=-15.44,95%CI -26.55 to -4.33,P=0.006;I^2=90%;5 trials],BUN[MD=-1.83,95%CI -2.97 to -0.70,P=0.002;I^2=93%;4 trials]and TG[MD=-0.69,95%CI-1.23 to -0.15,P=0.01;I^2=87%;4 trials],and improved clinical total effective rate[OR=3.89,95%CI 2.18 to 6.93,P<0.00001;I^2=0%;7 trials].Conclusions The treatment of acupuncture has a favorable therapeutic efficacy for DKD.It can significantly reduce UAE and blood lipid and can improve renal function and effectiveness of clinical treatment of DKD.Importance should be attached to the acupoints of Shenshu(BL 23),Guanyun(RN 4),Zusanli(ST 36),Taixi(KI 3),etc.,in clinical practice.

关 键 词：糖尿病肾脏病 针刺治疗 META分析 随机对照试验 

分 类 号：R256.59[医药卫生—中医内科学]