黄芪颗粒治疗糖尿病肾病的系统评价

Astragalus granules for diabetic nephropathy: A systematic review

目的探讨及评价黄芪颗粒治疗糖尿病肾病的临床疗效。方法检索并筛选从建库至2016年8月30日主要中英文数据库中联合黄芪颗粒治疗糖尿病肾病的随机对照试验研究。应用Cochrane评价员手册、Jadad评分法进行偏倚风险以及质量评价。应用RevMan5.3软件进行Meta分析。结果符合纳入标准的文献共4篇。与对照组相比,治疗组联合黄芪颗粒治疗,临床疗效总有效率比值比(OR)为5.73,95%CI (2.84,11.58),差异有统计学意义(P<0.00001);24 h尿微量白蛋白均数差(MD)为-30.21,95%CI(-34.82,-25.59),差异有统计学意义(P<0.00001);总胆固醇MD为-1.08,95%CI(-1.83,-0.32),差异有统计学意义(P=0.005);甘油三酯MD为-0.96,95%CI(-1.85,-0.06),差异有统计学意义(P=0.04);肌酐MD为-8.12,95%CI(-15.21,-1.03),差异有统计学意义(P=0.02);纳入研究未报道不良反应。结论联合黄芪颗粒治疗糖尿病肾病的临床疗效明显,且无不良反应。但需更多大样本、高质量的临床研究来进一步验证联合黄芪颗粒治疗糖尿病肾病的临床疗效。

Objective To investigate and evaluate the clinical efficacy of Astragalus Granules in treating diabeticnephropathy. Methods All of the randomized controlled trials about the combination of Huangqi Granules for the treatment of diabetic nephropathy from the establishment of the database to the August 30, 2016 in major Chinese and English databases were searched and screened. Cochrane reviewer＇s manual and Jadad＇s method were used to assess the riskof bias and quality. RevMan5.3 software was used for meta-analysis. Results There were 4 articles that meet the inclusion criteria. Compared with the control group, the people in the treatment group was treated with combined Huangqigranules treatment, the total effective odds ratio of the clinical efficacy（OR） was 5.73, 95% confidence interval（CI） was（2.84, 11.58）, the difference was statistical significant（P〈0.00001）; the mean difference（MD） of 24-hour urine microwas -30.21, 95%CI was （-34.82, -25.59）, the difference was statistically significant （P〈0.00001）; the MD of totalcholesterol was -1.08, 95%CI was（-1.83, -0.32）, the difference was statistically significant （P=0.005）; the MD oftriglyceride was -0.96, 95%CI was（-1.85, -0.06）, the difference was statistically significant （P=0.04）; the MD of creatinine was -8.12, 95%CI was（-15.21,-1.03）, the difference was statistically significant（P=0.02）; adverse effects were notreported in the included studies. Conclusion The combination of Huangqi granules for the treatment of diabeticnephropathy is with obvious clinical efficacy and without any adverse reaction. However, more clinical studies withlarge samples and high-quality are needed to further verify the clinical efficacy of combined Huangqi Granule for thetreatment of diabetic nephropathy.