尿毒清治疗慢性肾脏病的系统评价

Systematic Assessment on Randomized Controlled Trials for Treatment of Chronic Kidney Disease by Niaoduqing

目的:评价尿毒清治疗慢性肾脏病的疗效和安全性。方法:收集使用尿毒清治疗慢性肾脏病的随机对照试验(RCT)。按纳入排除标准筛选试验、评价研究质量、提取有效数据,并采用Revman5.0进行统计分析。结果:共纳入27个RCT,均以中文发表,纳入文献质量均为C级。在常规治疗基础上,尿毒清在临床疗效和肾功能改善方面与空白对照比较差异有统计学意义;在改善血尿素氮和内生肌酐清除率方面与包醛氧淀粉比较差异有统计学意义;在改善血清肌酐方面与包醛氧淀粉没有统计学差异。尿毒清与其他中药(云南灯盏花胶囊、益肾宁方等)比较,在临床疗效、肾功能改善、24h尿蛋白、血压改善方面多不及其它中药。结论:由于纳入试验方法学质量普遍较低,缺乏必要的终点指标,尿毒清治疗慢性肾脏病的疗效及安全性尚不能确定,需开展大样本、高质量、设计合理的随机对照试验进一步证实。

Objective： To assess the effectiveness and safety of Niaoduqing in the treatment of chronic kidney disease. Methods： We searched for randomized controlled trials about Niaoduqing to treat chronic kidney disease.Trial screening, quality assessment of included trials, and data extract were conducted. Statistical analysis was conducted by using Revman 5.0 software. Results： A totol of 27 randomized controlled trials（RCT） in the Chinese language were identified.The rank of these RCTs was C. Niaoduqing plus common therapy was more effective than common therapy on clinical efficacy and renal function; Niaoduqing was more effective than Coated Aldehyde Oxystarch on BUN and Ccr; There was no significant different between Niaoduqing and Coated Aldehyde Oxystarch on Scr; Other traditional Chineses medicine were more effective than Niaoduqing on clinical efficacy, improvement of renal function, 24-hour urine protein and blood pressure. Conclusion： Due to the low methodological quality and small sample of trials included, more RCTs of high quality and large scale are required.