结肠透析联合尿毒清颗粒保留灌肠治疗慢性肾衰竭疗效的Meta分析

Effects of colonic dialysis combined with uremic clearance granule retention-enema on patients with chronic renal failure： a meta-analysis

目的 评价结肠透析联合尿毒清颗粒保留灌肠治疗慢性肾衰竭疗效.方法 计算机检索Cochrane图书馆资料库、MEDLINE（美国国立医学图书馆）、EMbase（荷兰医学文摘数据库）、万方数据、中国知网（CNKI）、中国生物医学文献数据库（CBM）.同时手工检索结肠透析联合尿毒清颗粒保留灌肠治疗慢性肾衰竭疗效的随机对照试验,检索时限均为建库至2013年11月,并追溯纳入研究的参考文献.由两位研究者按照纳入与排除标准独立筛选文献、提取资料和评价质量后,采用RevMan 5.1软件进行Meta分析.结果 共纳入9篇文献.其中8篇文献质量评价为C级,1篇文献评为B级.Meta分析显示,慢性肾衰竭患者经过结肠透析联合尿毒清颗粒保留灌肠治疗后：①血肌酐水平明显降低,差异有统计学意义（MD=-122.28,95％ CI：-172.43～-72.14,P＜0.01）;②血尿素氮水平明显降低,差异有统计学意义（MD=-4.08,95％ CI：-5.88～-2.27,P＜0.01）;③肌酐清除率明显升高,差异有统计学意义（MD=-2.79,95％ CI：1.82～3.75,P＜0.01）.结论 结肠透析联合尿毒清颗粒保留灌肠治疗慢性肾衰竭疗效确切.但由于目前的临床研究质量总体偏低,尚需进行严格的、多中心的随机双盲对照实验研究进一步证实.

Objective To review the effects of colonic dialysis combined with uremic clearance granule retention-enema on patients with chronic renal failure.Methods The databases of Cochrane？Library,MEDLINE,EMbase,WanFang,CNKI,CBM were retrieved by computer and hands for collecting the randomized controlled trials （RCTs） and relative literature about effects of colonic dialysis combined with uremic clearance granule retention-enema on patients with chronic renal failure from inception to November,2013.References of included studies were also retrieved.Two reviewers inde pendently screened literature,extracted data,and assessed the methodological quality.Then,meta-a nalysis was performed using RevMan 5.1 software.Results There were totally 9 RCTs enclosed.Eight trials were classified as grade C except one trial which was grade B.The results of Meta-analysis showed that the level of serum creatinine （SCr） was decreased significantly in patients after the treat ment with colonic dialysis combined with uremic clearance granule retention enema （MD=-122.28,95％ CI：-172.43～-72.14,P＜0.01）,the level of blood urea nitrogen （BUN） was decreased sig nificantly （MD=-4.08,95％ CI：-5.88～-2.27,P＜0.01）,and the creatinine clearance rate was increased significantly （MD=-2.79,95％ CI：1.82～3.75,P＜0.01）.Conclusions Colonic dialysis combined with uremic clearance granule retention-enema has definite curative effect in decreasing Scr and BUN levels on patients with chronic renal failure,which needs to be further confirmed by strict and multi-center randomized double-blinded controlled trials because the total quality of current clinical researches is lower.