银杏达莫与ARB联合治疗糖尿病肾病的Meta分析

Meta-analysis of ginkgo injection combined with ARB in the treatment of diabetic nephropathy

目的评价银杏达莫联合血管紧张素Ⅱ受体拮抗剂(angiotensin II receptor blockers,ARB)对糖尿病肾病的治疗效应。方法检索国内外公开发表的有银杏达莫与ARB联合治疗糖尿病肾病的随机对照试验(RCT),采用Cochrane系统评价手册进行质量评价,用RevMan 5.1.4软件进行Meta分析。结果共纳入9项研究分析,银杏达莫与ARB联合用药治疗组在降低尿微量白蛋白排泄率(UAER)、24h尿蛋白、尿白蛋白(U-Alb)、血肌酐(SCr)、血纤维蛋白原等临床指标疗效优于单用ARB组(P<0.05),但在降低尿素氮(BUN)、血甘油三酯(TG)以及胆固醇(TC)以及血浆粘度等指标上差异无统计学意义(P>0.05)。结论银杏达莫与ARB联合用药对早期糖尿病肾病有一定疗效,但由于现有研究样本数较少,文献质量存在一定方法学问题,尚需要严格设计的大样本的RCT加以证实。

Objective To evaluate the effectiveness of ginkgo injection combined with angiotensin II receptor blockers（ARB）in the treatment of early diabetic nephropathy（DN）.Methods Randomized controlled trials（RCT）on ginkgo injection combined with ARB for treating early DN were performed by the standard from Cochrane Reviewers＇Handbook 4.2.2 and analyzed by Rev-Man 5.1.4 sofeware.Results Nine RCTs were included in Meta analysis.Compared with ARB group,the therapeutic efficacy of ginko injection combined with ARB group was better in reducing urinary albumin excretion rates（UAER）,24h urine protein level,urinary albumin（U-Alb）,Serum creatinine（Scr） and serum fibrinogen（P0.05）.However,there was no significant difference in Blood urea nitrogen（BUN）,Triglyceride（TG）,total cholesterol（TC） and Plasma specific viscosity between ARB and ginko injection combined ARB groups（P0.05）.Conclusion The ginkgo injection combined ARB may hold potential therapeutic effects for treating early DN.Since some methodological problems existed in present research,the analytic results warrant further investigation in future research by strict-designed and large-scale sample randomized control trials.