中药保留灌肠治疗慢性肾衰竭的Meta分析

Retention enema by Chinese herbal medicine in the treatment of chronic renal failure: A Meta-analysis

目的系统评价中药保留灌肠治疗慢性肾衰竭的疗效。方法电子检索中国期刊全文数据库、中国生物医学文献数据库、维普数据库、万方数据库,并加以人工检索,全面收集中药保留灌肠治疗慢性肾衰竭的随机对照临床试验,检索时间截止于2015年3月10日,对符合标准的文献用Rev Man5.3进行Meta分析。结果共纳入13个随机对照研究,合计1 130例患者。Meta分析结果显示,中药保留灌肠联合西医治疗组治疗慢性肾衰竭的显效率优于单纯西医对照组(RR=2.02,95%CI:1.66~2.45,P<0.000 01);治疗组总有效率亦优于对照组(RR=1.48,95%CI:1.37~1.61,P<0.000 01);中药保留灌肠组较对照组降低血肌酐更为明显(WMD=-50.99,95%CI:-69.26^-32.72,P<0.000 01);中药保留灌肠组较对照组显著改善尿素氮水平(WMD=-3.70,95%CI:-5.06^-2.34,P<0.000 01)。结论中药保留灌肠联合西医治疗慢性肾衰竭,疗效确切,值得临床推广应用。

Objective To assess the efficacy of retention enema by Chinese herbal medicine in the treatment of chronic renal failure.Methods CNKI,CBM and weipu,wanfang database were searched for relevant studies about the randomized controlled clinical trials（ RCTs） in the treatment of chronic renal failure by herbal medicine retention enema published before March,2015. Standard studies were used for quality evaluation and a Meta- analysis performed by Review Manager 5. 3. Results 13 studies were included,involving1130 patients. Meta analysis showed that the efficiency was improved in treatment group compared with control group（ RR = 2. 02,95%CI： 1. 66 ~ 2. 45,P 0. 000 01）; and so was total effective rate（ RR = 1. 48,95% CI： 1. 37 ~ 1. 61,P 0. 000 01）; Compared with control group,the serum creatinine were decreased significantly in treatment group（ MD =- 50. 99,95% CI：- 69. 26 ^- 32. 72,P 0. 000 01）; and so was blood urea nitrogen（ MD =- 3. 70,95% CI：- 5. 06 ^- 2. 34,P 0. 000 01）. Conclusion The current limited evidence suggests that the efficacy of enema by Chinese herbal medicine in the treatment of chronic renal failure is better than the traditional protocols,which is worth to be popularized.