当归拈痛汤加减治疗湿热阻络型痛风性肾病的Meta分析  

Meta Analysis of Modified Danggui Niantong Decoction in Treating Damp-heat Blocking Collateral Gouty Nephropathy

作　　者：周熙谋 顾霜 何伟明[1] ZHOU Xi-mou;GU Shuang;HE Wei-ming(Department of Nephrology,Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,Jiangsu,China)

机构地区：[1]南京中医药大学附属医院肾内科,江苏南京210029

出　　处：《医学信息》2021年第12期101-105,110,共6页Journal of Medical Information

摘　　要：目的评价当归拈痛汤加减治疗湿热阻络型痛风性肾病有效性及安全性。方法计算机检索PubMed、EMbase、Cochrane Library、CNKI、SinoMed、万方数据库、维普,查找筛选当归拈痛汤加减治疗湿热阻络型痛风性肾病的随机对照研究文献,并采用Cochrane风险评估工具对纳入研究进行质量评估,用RevMan 5.3软件对数据进行分析。结果共纳入6项研究,479例患者。Meta分析结果表明,当归拈痛汤加减联合降尿酸治疗有效率高于单纯降尿酸治疗[RR=1.24,95%CI(1.14,1.34),P<0.00001],并且能够有效降低血尿酸[MD=-49.75,95%CI(-59.63,-39.88),P<0.0001]、肌酐[SMD=-1.73,95%CI(-2.36,-1.10),P<0.00001]、24h尿蛋白定量[MD=-0.52,95%CI(-0.70,-0.35),P<0.00001]、血尿素氮[SMD=-1.21,95%CI(-2.00,-0.42),P=0.003]、血β2-MG[SMD=-1.64,95%CI(-2.24,-1.04),P=0.003]水平;两组不良事件发生率比较,差异无统计学意义[RR=0.39,95%CI(0.12,1.20),P=0.10]。结论当归拈痛汤加减联合降尿酸治疗能够有效降低湿热阻络型痛风性肾病患者尿酸、肌酐、血尿素氮等指标,延缓肾功能进展,不增加不良事件的发生率,安全有效。Objective To evaluate the effectiveness and safety of Danggui Niantong Decoction in the treatment of gouty nephropathy with damp-heat blocking collaterals.Methods Computer searched PubMed,EMbase,Cochrane Library,CNKI,SinoMed,Wanfang database,Weipu,searched and screened the randomized controlled study literature of Danggui Niantong Decoction in the treatment of damp-heat block gout nephropathy,and used Cochrane risk assessment tool conduct quality assessments,RevMan 5.3 software was used to analyze the data.Results A total of 6 studies with 479 patients were included.Meta-analysis results showed that the effective rate of Danggui Niantong Decoction combined with lowering uric acid was higher than that of uric acid lowering alone[RR=1.24,95%CI(1.14,1.34),P<0.00001],and can effectively reduce blood uric acid[MD=-49.75,95%CI(-59.63,-39.88),P<0.0001],creatinine[SMD=-1.73,95%CI(-2.36,-1.10),P<0.00001],24 h urine protein quantitative[MD=-0.52,95%CI(-0.70,-0.35),P<0.00001],blood urea nitrogen[SMD=-1.21,95%CI(-2.00,-0.42),P=0.003],bloodβ2-MG[SMD=-1.64,95%CI(-2.24,-1.04),P=0.003]level,there was no statistically significant difference in the incidence of adverse events between the two groups[RR=0.39,95%CI(0.12,1.20),P=0.10].Conclusion Danggui Niantong Decoction combined with lowering uric acid treatment can effectively reduce uric acid,creatinine,blood urea nitrogen and other indicators in patients with damp-heat blocking gouty nephropathy,delay the progression of renal function,and do not increase the incidence of adverse events.It is safe and effective.

关 键 词：当归拈痛汤 痛风性肾病 湿热阻络 尿酸 

分 类 号：R256.5[医药卫生—中医内科学]