联合应用雷公藤多苷治疗Ⅳ期糖尿病肾病的Meta分析

【摘要】 目的 系统评价联用雷公藤多苷治疗Ⅳ期糖尿病肾病(DKD)的临床疗效及安全性。方法 检索中国期刊全文数据库、万方数据库、维普中文科技期刊全文数据库、中国生物医学文献数据库收录的关于联用雷公藤多苷治疗Ⅳ期DKD的随机对照试验,纳入的文献进行方法学质量评价,并采用Rev Man 5.3软件进行Meta分析,评价指标包括临床疗效、ALB、Scr及安全性评价。结果 纳入符合标准文献11篇,涉及患者859例,Meta分析结果显示:联用雷公藤多苷治疗Ⅳ期DKD的临床总有效率明显高于对照组(OR=0.26,95%CI[0.16,0.44]);联用雷公藤多苷较单用ACEI/ARB更能降低Ⅳ期DKD患者的ALB(SMD=6.37,95%CI[3.54,9.20]);联用雷公藤多苷在降低Scr方面无临床价值(SMD=-6.78,95%CI[-19.84,6.28]),不良反应的发生率也高于对照组(OR=1.23,95%CI[0.58,2.59]),但经对症处理均好转,未影响试验结果。结论 联用雷公藤多苷治疗Ⅳ期DKD在提高临床疗效、降低ALB方面具有优势,但尚需更多高质量研究做进一步分析论证。更多还原

【Abstract】 Objective To evaluate the effect and safety of combined use of tripterygium glucosides in treating diabetic kidney disease( DKD)stage IV systematically. Methods Randomized controlled trials about combined use of tripterygium glucosides in treating DKD stage IV were reviewed in China National Knowledge Infrastructure, VIP Database, Wanfang Database, Chinese Bio Medical Database. The methodology quality of included papers was evaluated. Rev Man 5.3 software was adopted to make Meta analysis. The evaluation indexes included clinical effect evaluation, ALB, Scr and safety evaluation. Results 11 papers met the standard were included, about 859 patients. Meta analysis manifested that the total clinical efficacy in combined use of tripterygium glucosides group was obviously superior to that in the controlled group( OR=0.26,95%CI [0.16, 0.44 ]); combined use of tripterygium glucosides could decrease the level of ALB( SMD=6.37, 95%CI [ 3.54, 9.20 ]) better than ACEI/ARB drugs single-used it had no significant difference in decreasing Scr with controlled group(P>0.05). However, it showed that combined use of tripterygium glucosides had a higher rate of adverse reactions( OR= 1.23, 95%CI[0.58, 2.59]). Conclusion Combined use of tripterygium glucosides in treating DKD stage IV has advantages in improving clinical efficacy, decreasing ALB, but more high-quality researches are needed to make further analysis and demonstration.更多还原