【摘要】 目的运用循证医学的方法,评价中医药治疗糖尿病肾病(DN)血糖血脂的疗效。方法收集中西医结合与单纯西医药治疗DN的随机对照试验(RCT)和半随机对照试验(CCT),采用Revman4.2.2软件进行Meta分析。结果纳入56篇RCT和1篇CCT,全部论文被评为C级。Meta分析结果显示:与单纯西医药治疗相比,中西医结合治疗可进一步降低DN患者空腹血糖(WMD=-0.65,95%CI(-0.90,-0.40),P<0.00001)、糖化血红蛋白(WMD=-0.42,95%CI(-0.71,-0.14),P=0.004)、胆固醇(WMD=-0.91,95%CI(-1.16,-0.66),P<0.00001)、三酰甘油(WMD=-0.51,95%CI(-0.68,-0.35),P<0.00001)。结论中医药对DN患者有一定的降糖降脂作用,但由于本系统评价所纳入研究存在方法学上的缺陷,故中医药对DN患者血糖血脂的疗效尚需进一步研究。更多还原

【Abstract】 Objective To assess the effect of Chinese herbal medicine on hyperglycemia and hyperlipidemia of diabetic nephropathy(DN) . Methods Randomized or semi-randomized controlled trials(RCT or CCT) which compared combined treatment of Chinese medicine and western medicine with western medicine alone were collected.Meta-analysis was performed. Results 56 Chinese RCTs and 1 CCT were included in this review.All trials were classified as grade C.The results of meta-analysis demonstrated that compared with western medicine alone,combination with Chinese medicine could significantly decrease fasting blood glucose(WMD=-0.65,95%CI(-0.90,-0.40) ,P<0.000 01) ,glycosylated hemoglobin(WMD=-0.42,95%CI(-0.71,-0.14) ,P=0.004) ,cholesterol(WMD=-0.91,95%CI(-1.16,-0.66) ,P<0.000 01) and triglyceride(WMD=-0.51,95%CI(-0.68,-0.35) ,P<0.000 01) . Conclusion Chinese herbal medicine showed an encouraging comparative effectiveness on hyperglycemia and hyperlipidemia of DN.But the poor methodological quality of included studies seriously weakened the validity of the meta-analysis.More RCTs with higher qualities are required.更多还原