王岚, 王小琴. 温阳活血利水法治疗糖尿病肾病的Meta分析[J]. 临床肾脏病杂志, 2017, 17(1): 12-19. DOI: 10.3969/j.issn.1671-2390.2017.01.003
    引用本文: 王岚, 王小琴. 温阳活血利水法治疗糖尿病肾病的Meta分析[J]. 临床肾脏病杂志, 2017, 17(1): 12-19. DOI: 10.3969/j.issn.1671-2390.2017.01.003
    WANG Lan, WANG Xiao-qin. Warming Yang, Promoting Blood Circulation and Inducing Diuresis in the treatment of diabetic nephropathy: a meta-analysis[J]. Journal of Clinical Nephrology, 2017, 17(1): 12-19. DOI: 10.3969/j.issn.1671-2390.2017.01.003
    Citation: WANG Lan, WANG Xiao-qin. Warming Yang, Promoting Blood Circulation and Inducing Diuresis in the treatment of diabetic nephropathy: a meta-analysis[J]. Journal of Clinical Nephrology, 2017, 17(1): 12-19. DOI: 10.3969/j.issn.1671-2390.2017.01.003

    温阳活血利水法治疗糖尿病肾病的Meta分析

    Warming Yang, Promoting Blood Circulation and Inducing Diuresis in the treatment of diabetic nephropathy: a meta-analysis

    • 摘要: 目的 系统评价温阳活血利水法治疗糖尿病肾病(diabetic nephropathy,DN)的疗效及安全性。方法 电子检索外文数据库PubMed、EMbase、The Cochrane Library及中国期刊全文数据库、中国生物医学文献数据库、万方数据库、维普数据库,并辅以手工检索,全面收集温阳活血利水法治疗DN的随机对照临床研究,检索时间为建库至2016年4月1日,对符合标准的文献采用RevMan 5.3软件进行Meta分析。结果 共纳入16个临床随机对照试验,合计1 107例DN患者。Meta分析结果显示:以温阳活血利水法为主的中西医结合治疗组治疗DN显效率、总有效率优于西医常规对照组(RR=1.97,95% CI 1.50~2.59,Z=4.86,P<0.01;RR=1.48,95% CI 1.35~1.62,Z=8.58,P<0.01);治疗组较对照组降低血肌酐明显(MD=-32.33,95% CI -58.20~-6.47,Z=2.45,P=0.01);升高高密度脂蛋白效果明显(MD=0.16,95% CI 0.09~0.23,Z=4.33,P<0.01);降低胆固醇、三酰甘油、低密度脂蛋白效果明显(胆固醇MD=-0.82,95% CI -1.28~-0.36,Z=3.49,P=0.000 5;三酰甘油MD=-0.40,95% CI -0.53~-0.26,Z=5.95,P<0.01;低密度脂蛋白MD=-0.49,95% CI -0.76~-0.21,Z=3.46,P=0.000 5);减少尿蛋白效果更明显(MD=-0.46,95% CI -0.61~-0.31,Z=6.01,P<0.01);在控制空腹血糖方面更为明显(MD=-0.34,95% CI -0.57~-0.12,Z=3.00,P=0.003);而在降低肿瘤坏死因子-α水平方面疗效相当(P=0.33)。结论 以温阳活血利水法为主的中西医结合方法治疗DN的临床综合疗效显著优于西医常规治疗方法,且安全性较好,值得在临床推广应用。

       

      Abstract: Objective To evaluate the efficacy and safety of ‘Warming Yang, Promoting Blood Circulation and Inducing Diuresis’ in the treatment of diabetic nephropathy (DN).Methods The used electronic databases contained foreign databases such as PubMed, EMBASE, Cochrane Library, and Chinese databases such as CNKI, SinoMed, Wanfang Data, CQVIP. The clinical data of "Warming Yang, Promoting Blood Circulation and Inducing Diuresis" in treatment of DN were collected comprehensively. The literature retrieval ended on April 1, 2016, and the meta analysis of appropriate literature was processed by RevMan5.3 software.Results The cases of randomized controlled trials totaled 16 and the cases of DN patients totaled 1 107. The results of Meta analysis showed that compared to western medicine control group, the experimental group of integrated traditional Chinese medicine and western medicine, based on "Warming Yang and Benefiting Qi, Promoting Blood Circulation and Inducing Diuresis", performed better in the significant efficiency and total efficiency of the treatment of DN (RR=1.97, 95% CI 1.50~2.59, Z=4.86, P<0.01; RR=1.48, 95% CI 1.35~1.62, Z=8.58, P<0.01), in the decrease of the serum creatinine (MD=-32.33, 95% CI -58.20~-6.47, Z=2.45, P=0.01), in the increase of high density lipoprotein (MD=0.16, 95% CI 0.09~0.23, Z=4.33, P<0.01), in the decrease of cholesterol, triglyceride, low density lipoprotein (MD=-0.82, 95% CI 1.28~-0.36, Z=3.49, P=0.000 5; MD=-0.40, 95% CI -0.53~-0.26, Z=5.95, P<0.01; MD=-0.49, 95% CI -0.76~-0.21, Z=3.46, P=0.000 5), in the decrease of urinary protein (MD=-0.46, 95%I -0.61~-0.31, Z=6.01, P<0.01), in the control of fasting blood glucose (MD=-0.34, 95% CI -0.57~-0.12, Z=3.00, P=0.003), and performed the same in the decrease of the levels of tumor necrosis factor alpha (P=0.33).Conclusions The current limited evidence suggests that the efficacy and safety of integrated traditional Chinese medicine and western medicine in the treatment of DN is better than the traditional protocols alone.

       

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