摘要
目的:系统评价猪苓汤联合血管紧张素转化酶抑制剂(ACEI)或血管紧张素受体阻滞剂(ARB)治疗糖尿病肾病(DKD)的疗效与安全性。方法:计算机检索CNKI、VIP、CBM、WAN-Fang Data、Pubmed、EMbase、Cochrane Library等数据库关于猪苓汤联合ACEI/ARB治疗DKD的随机对照试验(RCT),检索时间从各数据库建库至2020年6月。根据Cochrane系统评价方法对文献进行质量评价,采用Review Manager5.3软件进行Meta分析。结果:纳入9篇RCT,涉及680例患者,其中试验组345例,对照组335例。Meta分析结果显示:猪苓汤联合ACEI/ARB在提高总有效率[RR=1.23,(95%CI:1.13,1.33),P<0.05],降低24h尿蛋白定量[MD=-0.42,(95%CI:-0.52,-0.32),P<0.05]、血肌酐[MD=-16.85,(95%CI:-25.64,-8.06),P=0.0002]、尿素氮[MD=-1.41,(95%CI:-2.38,-0.44),P=0.005]、甘油三脂[MD=-0.25,(95%CI:-0.43,-0.07),P=0.008]等方面优于对照组;猪苓汤联合ACEI或ARB在降低空腹血糖[MD=-0.31,(95%CI:-0.69,0.06),P=0.10]方面与对照组疗效相当。结论:猪苓汤联合ACEI或ARB治疗DKD患者具有一定的优势,但本次研究的文献质量较低,该结论尚需开展更多高质量的RCT加以支持。
Objective:To systematically evaluate the efficacy and safety of Zhuling decoction combining with angiotensin converting enzyme inhibitor(ACEI)or angiotensin receptor blocker(ARB)in treating diabetic kidney disease(DKD).Methods:We searched the CNKI,WAN-Fang Data,VIP,CBM,Pubmed,EMbase,Cochrane Library online Data bases June,2020.All of the randomized controlled trials(RCTs)of Zhuling decoction combining with ACEI/ARB in treating for DKD were searched.The quality of the literature was evaluated by the Cochrane.Meta-analysis was performed using Review Manager 5.3 software.Results:Totally 9 RCTs were included into the study,involving 680 patients,including 345 in the experimental group and 335 in the control group.Meta-analysis results show:compared with the control group,Zhuling decoction combining with ACEI/ARB was much better in the improving total effective rate[RR=1.23,(95%CI:1.13,1.33),P<0.05];decreasing 24 hurine protein quantitation[MD=-0.42,(95%CI:-0.52,-0.32),P<0.05]、serum creatinine[MD=-16.85,(95%CI:-25.64,-8.06),P=0.0002],blood urea nitrogen[MD=-1.41,(95%CI:-2.38,-0.44),P=0.005],triglyceride[MD=-0.25,(95%CI:-0.43,-0.07),P=0.008];there was no significant difference between the control group and the Zhuling decoction combining with ACEI/ARB in reducing fasting blood glucose[MD=-0.31,(95%CI:-0.69,0.06),P=0.10].Conclusion:Zhuling decoction has certain advantages in the treatment of patients with DKD,but the quality of the literature in this study is low.This conclusion needs to be supported by more high-qualityRCTs.
作者
张李博
孙路
吴金鸿
王瑶
郭婷婷
秦水锋
刘光珍
Zhang Libo;Sun Lu;Wu Jinhong;Wang Yao;Guo Tingting;Qin Shuifeng;Liu Guangzhen(Shanxi University of Traditional Chinese Medicine,Taiyuan 030024,China;Shanxi Academy of Chinese Medicine,Taiyuan 030012,China)
出处
《亚太传统医药》
2021年第6期128-133,共6页
Asia-Pacific Traditional Medicine
基金
山西省科技攻关项目(2016ZD0307)
晋药综合开发利用协同创新中心项目(2017-JYXT-32)
山西省重点研发计划重点项目计划(201603D3113023)
山西省重点研发计划(指南)(201703D421024)
山西中医药大学研究生教育创新计划(2020JG001)
