芪葵颗粒联合代谢控制治疗气阴两虚、湿瘀阻络型糖尿病肾病有效性及安全性Meta分析

Meta-analysis of Efficacy and Safety of Qikui Granule(芪葵颗粒)Combined with Metabolic Control in Treatment of Diabetic Nephropathy with Deficiency of Qi and Yin and Dampness and Blood Stasis Blocking Collaterals Type

目的系统评价芪葵颗粒联合代谢控制治疗气阴两虚、湿瘀阻络型糖尿病性肾病(DN)的临床疗效。方法计算机检索中国知网期刊全文数据库、万方医药期刊数据库、维普中文科技期刊全文数据库及PubMed、Web of Science、ScienceDirect,搜索芪葵颗粒治疗DN的随机对照研究,检索时间自建库至2022年3月。由两位研究者独立筛选文献、提取资料并评估纳入研究的偏倚风险后,采用Revman 5.4.1软件进行分析。结果共纳入9项随机对照研究,638例DN患者,涉及主要疗效指标五项。Meta分析结果显示:降尿蛋白有效率[RR=0.72,95%CI(0.64,0.80),P<0.00001]、UACR[WMD=12.54,95%CI(2.40,22.67),P=0.02]、BUN[WMD=0.67,95%CI(0.53,0.80),P<0.00001]、24h-UTP[WMD=25.26,95%CI(17.30,33.23),P<0.00001]、Scr[WMD=3.92,95%CI(2.61,5.24),P<0.00001]等疗效指标均优于对照组,其差异具有统计学意义。结论根据目前临床证据表明,芪葵颗粒治疗DN有显著疗效。

Objective To systematically evaluate the clinical efficacy of Qikui Granule(芪葵颗粒)combined with metabolic control in the treatment of diabetic nephropathy(DN)with deficiency of Qi and Yin and dampness and blood stasis blocking collateral type.Methods The randomized controlled study on Qikui Granule in the treatment of DN was searched from CNKI,Wanfang,Weipu,PubMed,Web of Science and ScienceDirect.The search time was from self-built database to March 2022.Two researchers independently screened the literature,extracted the data and assessed the risk of bias in the included study.Revman 5.4.1 software was used for analysis.Results A total of 9 randomized controlled studies were included,including 638 patients with DN,involving five main efficacy indicators.Meta-analysis results showed that the effective rate of lowering urinary protein[RR=0.72,95%CI(0.64,0.80),P<0.00001],urine microalbumin/creatinine(UACR)[WMD=12.54,95%CI(2.40,22.67),P=0.02],blood urea nitrogen(BUN)[WMD=0.67,95%CI(0.53,0.80),P<0.00001],24-hour urine protein quantification(24 h-UTP)[WMD=25.26,95%CI(17.30,33.23),P<0.00001]and serum creatinine concentration(Scr)[WMD=3.92,95%CI(2.61,5.24),P<0.00001)].The difference was statistically significant.Conclusion According to the present clinical evidence,Qikui Granule has significant therapeutic effect on DN.