1例2型糖尿病肾病尿微量白蛋白期患者的循证治疗

目的:以循证医学的方法为1例2型糖尿病肾病尿微量白蛋白期患者确定治疗目标和治疗方案。方法:根据患者的情况,提出临床问题,从Cochrane图书馆(2009年第4期)、Medline(Pubmed网站1998-2009)及EMBASE(1998-2009)上进行检索,对所获证据进行评价,制定治疗方案。结果:共检索出与不同临床问题相关的随机对照实验17篇,系统评价或meta-分析11篇。证据显示通过对影响糖尿病肾病发展的因素进行治疗,可明显提高治疗效果,经过半年的随访后证实,该方案适合患者。结论:采取循证治疗的方法,为2型糖尿病肾病尿微量白蛋白期患者确定治疗目标和治疗方案,能有效延缓病情发展。

Objective To make an individulized treatment for a patient diagnosed type 2 diabetic nephropathy with microalbuminuria with the method of evidence - based medicine.Methods According to the clinical problems of the patient, evidence was searched from Cochrane Library（fourth issue, 2009）, Medline（PubMed 1998- 2009） and EMBASE（ 1998- 2009） for the decision- making treatment according to the search strategy. Rest/Its There are 17 RCTs and II systematic reviews or metaanalysis that were identified about clinical problems. The evidence indicated that the treatment efficacy has been improved after the progression of diabetic nephropathy inthe intervention. And after a half of year followup, the treatment plan was proved optimal. Conclusion The progression of a patient diagnosed type 2 diabetic nephropathy with microalbuminuria can be delayed by determining an individulized treatment plan according to the evidencebased methods.