单纯针灸及联合中药治疗糖尿病肾病疗效的Meta分析  

A Meta-analysis of the efficacy of acupuncture alone comparision with acupuncture plus Chinese medicine in the treatment of diabetic kidney disease

作　　者：令娟 谢卓霖 王燕[2] 崔岩 杨蕾[1] 张定华[3] 史晓伟[3] 张东鹏[3] 罗向霞[3] LING Juan;XIE Zhuolin;WANG Yan;CUI Yan;YANG Lei;ZHANG Dinghua;SHI Xiaowei;ZHANG Dongpeng;LUO Xiangxia

机构地区：[1]甘肃中医药大学,甘肃兰州730030 [2]甘肃省人民医院,甘肃兰州730030 [3]甘肃省中医院,甘肃兰州730050

出　　处：《中医临床研究》2024年第30期9-17,共9页Clinical Journal Of Chinese Medicine

基　　金：甘肃省省级人才重点项目(甘组通字[2024]4号);国家自然科学基金项(8236150800,82360955);兰州市人才创新创业专项(2019-RC-62);甘肃省自然科学基金优秀博士生项目(24JRRA614);甘肃省人民医院院内科研基金项目(23GSSYF-9);甘肃中医药大学研究生创新创业基金项目(甘中医大研发[2024]48号);甘肃省卫生健康行业科研计划项目(GSWSKY2022-44);甘肃省名中医张定华传承工作室建设项目(甘卫中医函【2022】50号)。

摘　　要：目的:系统评价单纯针刺及针刺联合中药治疗糖尿病肾脏病(Diabetic Kidney Disease,DKD)的临床疗效。方法:计算机检索PubMed、EMbase、Cochrane Library、中国生物医学文献数据库(CBM)、中国知网、万方和维普数据库等,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STATA 15.0软件进行Meta分析。结果:共纳入研究41篇,涉及3 190例患者。Meta分析结果显示,在降低24 h尿蛋白定量(24-hour Urinary Protein,24 h UPQ)方面,单纯针灸组[标准均数差(SMD)=-0.65,95%置信区间(CI)=-0.83,-0.46)]及针灸联合中药组(SMD=-0.99,95%CI=-1.17,-0.81)优于基础治疗组;在降低24 h尿微量白蛋白排泄率方面,单纯针灸组(SMD=-1.45,95%CI=-1.65,-1.25)及针灸联合中药组(SMD=-1.44,95%CI=-1.58,-1.29)优于基础治疗组;在降低空腹血糖(Glucose,GLU)方面,单纯针灸组(SMD=-1.99,95%CI=-2.22,-1.76)及针灸联合中药组(SMD=-0.55,95%CI=-0.69,-0.41)优于基础治疗组,在降低糖化血红蛋白(Glycosylated Hemoglobin,HbAlc)方面,单纯针灸组(SMD=-1.95,95%CI=-2.15,-1.75)及针灸联合中药组(SMD=-0.57,95%CI=-0.75,-0.39)优于基础治疗组;在降低血肌酐(Serum Creatinine,Scr)方面,单纯针灸组(SMD=-8.32,95%CI=-10.71,-5.93)及针灸联合中药组(SMD=-8.23,95%CI=-8.61,-7.85)优于基础治疗组;在降低三酰甘油(Triglycerides,TG)方面,单纯针灸组(SMD=-0.97,95%CI=-1.15,-0.79)及针灸联合中药组(SMD=-1.18,95%CI=-1.36,-1.01)优于基础治疗组;在总有效率方面,单纯针灸组(SMD=1.14,95%CI=1.03,1.27)及针灸联合中药组(SMD=1.14,95%CI=-1.05,1.24)优于基础治疗组。结论:单纯针灸及针灸联合中药治疗糖尿病肾病可以有效降低患者血糖和血脂水平,减少尿蛋白的排泄,改善患者肾功能,提高患者的生活质量。Objective: To systematically evaluate the clinical efficacy of acupuncture alone and acupuncture combined with traditional Chinese medicine in the treatment of diabetic kidney disease(DKD). Methods: The data of relevant literature in Pub Med, EMbase, Cochrane Library, CBM, CNKI, Wanfang and VIP databases was searched and selected by computer, and literature quality was evaluated by two researchers. Meta-analysis was performed using STATA 15.0 software. Results: A total of 41 studies with 3 190 patients were included. The results of Meta-analysis showed that the acupuncture alone group(SMD=-0.65, 95%CI=-0.83,-0.46) and the acupuncture combined with traditional Chinese medicine group(SMD=-0.99, 95%CI=-1.17,-0.81) were superior to the basic treatment group in reducing the quantity of 24-hour urinary protein. In terms of reducing urinary microalbumin excretion rate at 24 hours, the acupuncture alone group(SMD=-1.45, 95%CI=-1.65,-1.25) and the acupuncture combined with traditional Chinese medicine group(SMD=-1.44, 95%CI=-1.58,-1.29) were superior to the basic treatment group. In terms of reducing GLU, the acupuncture alone group(SMD=-1.99, 95%CI=-2.22,-1.76) and the acupuncture combined with traditional Chinese medicine group(SMD=-0.55, 95%CI=-0.69,-0.41) were superior to the basic treatment group. In terms of reducing Hb Alc, the acupuncture alone group(SMD=-1.95, 95%CI=-2.15,-1.75) and the acupuncture combined with traditional Chinese medicine group(SMD=-0.57, 95%CI=-0.75,-0.39) were better than the basic treatment group. In terms of reducing Scr, the acupuncture alone group(SMD=-8.32, 95%CI=-10.71,-5.93) and the acupuncture combined with traditional Chinese medicine group(SMD=-8.23, 95%CI=-8.61,-7.85) were superior to the basic treatment group. In terms of TG reduction, the acupuncture alone group(SMD=-0.97, 95%CI=-1.15,-0.79) and the acupuncture combined with traditional Chinese medicine group(SMD=-1.18, 95%CI=-1.36,-1.01) were superior to the basic treatment group. In terms of total effective rate, the acupunctur

关 键 词：针灸 糖尿病肾病 META分析 

分 类 号：R587.1[医药卫生—内分泌]