六味地黄丸(汤)及其加减方治疗糖尿病肾脏病的系统评价

Systematic Assessment of Liuwei Dihuang Decoction and Its Additional and Subtractive Recipes in Treating Diabetic Renopathy

目的:系统评价六味地黄丸(汤)及其加减方治疗糖尿病肾脏病(DKD)的疗效及安全性。方法:计算机检索Cochrane图书馆临床对照试验库、MEDLINE、中国期刊全文数据库(CNKI),中国生物医学文献数据库和中文科技期刊全文数据库等。收集六味地黄丸(汤)及其加减方治疗糖尿病肾脏病的随机或半随机对照试验。由两名研究者独立选择试验、提取资料,并按照Cochrane系统评价的方法评价纳入研究的质量和提取有效数据,而后应用RevMan5.0.24软件进行Meta分析。结果:共纳入20篇文献,共计1318例患者。大部分试验方法质量学较低且样本含量小。"漏斗图"呈不对称分布,提示可能存在发表偏倚及试验方法质量低下,发表偏倚提示阴性结果的试验可能未发表。结论:六味地黄丸(汤)及其加减方可能是一种相对安全和有效治疗糖尿病肾脏病的药物。由于纳入试验方法质量低下和可能存在发表偏倚,使本系统评价的证据强度不足,有待进一步进行大样本、高质量的多中心随机双盲对照试验来证实。

Objective：The objective was to systematically assess curative effect and security of Liuwei Dihuang decoction and its additional and subtractive recipes in treating diabetic renopathy（DKD）.Methods：Computer search in clinical checking experimental storehouse of Cochrane library,MEDLINE,CNKI,China biomedicine literature database and Chinese science and technology periodical full text database and so on.Collect stochastic or half stochastic checking experiments in treating diabetic renopathy by Liuwei Dihuang decoction and its additional and subtractive recipes.Independent sampling test,extraction of material,assessment of the quality of integrated research and extraction of valid data were done according to the Cochrane system.Then the Meta analysis was carried out with the RevMan 5.0.24 software by two researchers.Results：Altogether integrates 20 literatures,totally 1318 patients.Majority of testing methods are low in quality study,and the sample content is small.Asymmetrical distributes of the funnel chart＇ indicates that publication dominance exists and the quality of testing methods are low.The publication dominance indicates that experiments of negative results have not been possibly published.Conclusion：Liuwei Dihuang decoction and its additional and subtractive recipes may be one kind of relative safe and effective medicine in treating diabetic renopathy.Due to publication dominance existing and the low quality of testing methods,the intensity of evidence of this systematic assessment was insufficient.Further research on big sample,high quality,multi-centers,stochastic,and double blind checking experiments are needed.