补肾活血法治疗早期糖尿病肾病的系统评价

System evaluation of invigorating kidney and activating blood circulation for treating early diabetic nephropathy

目的:评价补肾活血法治疗早期糖尿病肾病的临床疗效与安全性。方法:计算机检索中国知网、维普中文科技期刊全文数据库、中国生物医学文献数据库、万方数字化期刊全文数据库、Pub Med。查找补肾活血法治疗早期糖尿病肾病的随机对照试验(RCT)。两名评价员独立评价纳入试验的方法学质量,采用Review Manager 5.3软件行Meta分析。结果:纳入10篇中文RCTs。Meta分析结果显示:在常规西药治疗基础上,补肾活血法联合西药可以进一步降低早期糖尿病肾病的尿微量白蛋白排泄率[P<0.05,MD=-25.95,95%CI(-38.36,-13.54),I^2=76%];提高有效率[P<0.05,OR=3.45,95%CI(2.30,5.19),I^2=0%];血肌酐[P=0.55,MD=-4.02,95%CI(-17.21,9.18),I^2=98%]差异无统计学意义。结论:补肾活血法联合西药治疗早期糖尿病肾病有一定疗效。该系统评价所纳入的文献质量偏低,补肾活血法治疗早期糖尿病肾病仍需深入研究。

Objective：To evaluate the clinical effect and safety of invigorating kidney and activating blood circulation on early diabetic nephropathy.Methods：The following databases were searched by computer：CNKI,VIP,Sino Med,Wan Fang and Pubmed.Randomized controlled trials（RCT） of treating early diabetic nephropathy with the method of invigorating kidney and activating blood circulation were collected.Two reviewers evaluated the methodological quality of included RCTs independently.Meta-analysis was made by Review Manager 5.3 software.Result：10 Chinese RCTs were included.The results of meta-analysis demonstrated that on the basis of treatment with conventional western medicine,the method of invigorating kidney and activating blood circulation combined with western medicine could further reduce UAER of early diabetic nephropathy [P〈0.05,MD =-25.95,95%CI（-38.36,-13.54）,I^2= 76% ],enhance the effective rate [P〈0.05,OR = 3.45,95% CI（2.30,5.19）,I^2=0%].The difference of SCR[P = 0.55,MD =-4.02,95% CI（-17.21,9.18）,I2= 98%] was not statistically significant.Conclusion：The method of invigorating kidney and activating blood circulation combined with western medicine has a certain effect in the treatment of early diabetic nephropathy.The quality of literatures which were included by this system evaluation is a little low.The method of invigorating kidney and activating blood circulation for treating early diabetic nephropathy needs still be deeply studied.