益气滋肾通络中药治疗糖尿病肾病疗效的Meta评价

Efficacy of Chinese Herbal Medicine For Supplementing Qi,Nourishing Kidney and Dredging Collaterals in Treatment of Diabetic Nephropathy: A Meta-analysis

目的:运用循证医学的方法,评价益气滋肾通络中药治疗糖尿病肾病(DN)的临床综合疗效。方法:在中国期刊全文数据库(CNKI)(2007-2011)检索,纳入以DN为研究对象,收集关于益气滋肾通络中药联合西医药与单纯西医药治疗DN的随机对照试验(RCT),采用Revman 4.2软件进行Meta分析。结果:共纳入16篇中文RCT,全部论文被评为C级,Meta分析结果显示:与单纯西医药治疗相比,在西医药基础上应用益气滋肾通络中药治疗DN的疗效明显优于单纯使用西医药治疗{z=9.00(P<0.00001)WMD=4.09,95%CI[3.01,5.56]},且中西医结合治疗DN不良反应发生少,症状表现轻微,使用相对安全。结论:根据现有的有限证据表明,益气滋肾通络中药联合西医药治疗DN较单纯采用西医药效果好,受纳入研究的数量和质量限制,以及系统评价存在方法学上的缺陷,故益气滋肾通络中药在治疗DN的疗效上仍需深入研究。

Objective ： To make use of the evidence - based medicine and evaluate the effectiveness of Chinese herbal medicine for supplementing Qi, nourishing kidney and dredging collaterals in the treatment of diabetic nephropathy. Methods ： Search the CNKI （2007 to 2011 ） to collect randomized controlled trials （RCTs） which compared Chinese herbal medicine for supplementing Qi,nourishing kidney and dredging collaterals with western medicine, and the meta - analyses was performed by using the Cochrane Collaborations Revman 4.2 software. Results ：The literature included 16 Chinese RCTs. All trials were classified as grade C. The results of Meta - analysis demonstrated that compared with western medicine alone, combination with Chinese herbal medicine for supplementing Qi, nourishing kidney and dredging collaterals could significantly decrease some indices of diabetic nephropathy { z = 9.00 （ P 〈 0. 00001 ） WMD = 4.09,95% CI [ 3.01,5.56 ] }. Conclusion ： Comparing with western medicine alone, combination with the traditional Chinese medicine （TCM） for supplementing Qi, nourishing kidney and dredging collaterals has some effect and is relatively safe in treating patients with diabetic nephropathy, however, because of few high quality literature and limited sample, further study is needed.