近十年中医药治疗慢性肾脏病临床研究证据图分析  

Evidence mapping analysis of clinical studies in treatment of chronic kidney disease with traditional Chinese medicine in recent ten years

作　　者：李清茹 葛自豪 黄思雨 张琳琪[2] 黎斌怡 LI Qing-ru;CE Zi-hao;HUANG Si-yu;ZHANG Lin-qi;LI Bin-yi(the Eighth Clinical School,Guangzhou University of Chinese Medicine,Foshan 528000,China;the First Afiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China;Shenzhen Bao'an Authentic Traditional Chinese Medicine Therapy Hospital,Shenzhen 518100,China)

机构地区：[1]广州中医药大学第八临床医学院,广东佛山528000 [2]河南中医药大学第一附属医院,河南郑州450000 [3]深圳宝安纯中医治疗医院,广东深圳518100

出　　处：《中国中药杂志》2024年第20期5610-5626,共17页China Journal of Chinese Materia Medica

基　　金：国家自然科学基金项目(82374381,81973806);第七批全国名老中医药专家学术经验继承项目(国中医药人教函[2022]76号);河南省中原千人计划-中原名医项目;河南省中医药科学研究重大专项(2019ZYZD05);深圳市医疗卫生三名工程项目(SZZYSM202311015);深圳市宝安区医疗卫生科研项目(2022JD064)。

摘　　要：中医药在治疗慢性肾脏病方面具有显著优势,但其临床研究证据尚需进一步汇总与完善。该研究采用证据图对近十年中医药治疗慢性肾脏病的临床研究进行系统性整理,旨在掌握该领域的现有证据水平,为当前面临的问题提供参考与依据。系统检索中、英文数据库2013年1月1日至2023年12月31日发表的相关文献。由2名研究者分别进行文献筛选与信息整理,利用文字描述与图表相结合展示数据,揭示证据分布状况。最终纳入1414篇相关文献,其中干预性研究1301篇,观察性研究77篇,系统评价/Meta分析30篇,指南/共识6篇。文献整体数量保持稳定,但近两年趋势略有下降。干预方式以口服中药为多,干预疗程以1~3个月为主。文献共涉及55种中药经方、29种中成药,以参芪地黄汤、加味六味地黄汤、真武汤、黑地黄丸、尿毒清颗粒发文量占比最高。文献纳入证型以脾肾两虚证为多。结局指标对肾功能和安全性关注度较高,对临床症状/体征、超声关注度不足。大部分随机对照试验都存在“未知偏倚风险”,系统评价/Meta分析的质量多为4~7分。结果表明,中医药治疗慢性肾脏病已开展了许多小规模、短周期的研究,取得进展,但在临床应用中建议以谨慎和科学的态度,深入验证和探索更有效的治疗方案。Traditional Chinese medicine(TCM)has significant advantages in treatment of chronic kidney disease,but its clinical research evidence needs to be further summarized and improved.By means of evidence mapping,this paper systematically categorized the clinical research on TCM in treating chronic kidney disease in recent ten years,so as to understand the existing evidence level in this field and offer a reference for addressing current issues.The relevant literature published between January 1,2013 and December 31,2023 was systematically searched in both Chinese and English databases.Literature screening and information sorting were carried out by two researchers,respectively,and data were presented by combining text descriptions with graphs to clearly reveal the distribution of evidence.A total of 1414 relevant literature were included,including 1301 intervention studies,77 observational studies,30 systematic reviews/Meta-analysis,and 6 guidelines/consensus.The overall number of literature remained stable,but the trend decreased slightly in recent two years.The intervention methods were mainly oral administration of TCM,and the intervention course was mainly 1-3 months.The literature involved a total of 55 kinds of TCM formula and 29 kinds of Chinese patent medicine,with Shenqi Dihuang Decoction,Jiawei Liuwei Dihuang Decoction,Zhenwu Decoction,Hei Dihuang Pills,and Niaoduqing Granules accounting for the highest proportion.The types of syndrome included in relevant literature were mainly spleen and kidney deficiency.Outcome indicators paid more attention to renal function and safety and less attention to clinical symptoms/signs and ultrasound results.Most randomized controlled trials had an"unknown risk of bias",and the quality scores of systematic review/Meta-analysis were mostly 4-7 points.The result shows that in the field of chronic kidney disease treatment,TCM has carried out many small-scale and short-term studies and has made a lot of progress.In clinical application,a cautious and scientific attitude should b

关 键 词：慢性肾脏病 中医药 证据图 方法学 随机对照试验 

分 类 号：R277.5[医药卫生—中医学]