中西医结合治疗糖尿病肾病随机对照试验的Meta分析

Meta Analysis of Randomized Controlled Trials of Chinese and Western Medicine Treating Diabetic Nephropathy

目的:研究分析中西医结合疗法治疗糖尿病肾病的临床效果及各相关指标的变化。方法:通过检索2005年—2015年中国期刊全文数据库(CNKI),中国生物医学数据库(CBM),万方数据库,维普数据库(VIP)中国内公开发表的中西医结合疗法治疗糖尿病肾病的随机对照试验(RCT),运用Rev Man 5.3软件对符合纳入标准的文献进行Meta分析,比较分析中西医结合疗法与单纯西医疗法治疗糖尿病肾病的临床效果,以及治疗后空腹血糖,血肌酐,尿素氮,24 h尿蛋白量的变化。结果:经过逐步筛选,最终纳入10个随机对照试验,共960例糖尿病肾病患者,Meta分析结果显示与对照组相比,中西医结合疗法治疗糖尿病肾病的总体疗效较好,差异具有统计学意义(P<0.05),患者治疗后空腹血糖,24 h尿蛋白量均降低,差异具有统计学意义(P<0.05),治疗后血肌酐、尿素氮无明显降低,差异不具有统计学意义(P>0.05)。结论:中西医结合治疗糖尿病肾病的疗效优于单纯西医治疗,在降低血糖、24 h尿蛋白量方面具有较好的疗效,因纳入文献样本有限以及文献质量不高,尚需大样本以及多中心随机对照双盲试验的高质量研究来加以验证。

Objective： To investigate the clinical effect of combined treatment of Chinese and Western medicine in treating diabetic nephropathy and the changes of related indexes. Methods： By searching published random control trail（ RCT） of integrated traditional Chinese and Western medicine treatment of diabetic nephropathy in China journal full text database（ CNKI）,Chinese biomedical database（ CBM）,Wanfang database and VIP database（ VIP） from 2005 to 2015.Rev man 5. 3 software was used to make a Meta-analysis. Comparatively analyze the clinical effect of combined Chinese and Western medicine and simple western medicine treatment of diabetic nephropathy,and after treatment,compare the changes of fasting blood glucose,serum creatinine,urea nitrogen and 24 hour urinary protein. Results： After step-selection,and ultimately 10 randomized controlled trials including 960 cases of diabetic nephropathy patients were involved.The Meta-analysis results showed that compared with the control group,the overall efficacy of combined traditional Chinese and Western medicine therapy of diabetic nephropathy is better and the difference had statistical significance（ P〈0. 05）. After treatment,fasting blood glucose and 24 hour urinary protein were decreased and the difference had statistical significance（ P〈0. 05）. The serum creatinine and blood urea nitrogen had no significant reduce and the difference did not have statistical significance（ P〉0. 05）. Conclusion： Combined traditional Chinese and Western medicine treatment of diabetic nephropathy has better curative effect than pure western medicine treatment and has a good therapeutic effect in lowering blood glucose and 24 h urine protein quantity. The sample documents and literature quality are not high. It still need large sample,multi center,double-blind,randomized controlled clinical trial of high quality to verify it.