阿魏酸钠联合黄芪注射液治疗糖尿病肾病的系统评价

Systematic Evaluation of Sodium Ferulate Combined with Astragalus Injection in Treatment of Diabetic Nephropathy

目的:系统评价阿魏酸钠联合黄芪注射液治疗糖尿病肾病(diabetic nephropathy,DN)的有效性及对相关血液、尿液指标水平的影响。方法:计算机检索EMBase、MEDLINE、PubMed、the Cochrane Library、中国知网、维普数据库及万方数据库等,收集阿魏酸钠联合黄芪注射液治疗DN的随机对照试验(对照组患者只采用常规降压、降糖、控制饮食及适量运动等基础治疗;观察组患者在对照组基础上加用阿魏酸钠、黄芪注射液),检索时间为数据库建库至2017年9月。提取所纳入文献的相关资料,进行方法学质量评价,采用Review Manager 5.3.5软件进行文献荟萃分析(Meta分析)。结果:最终纳入10篇文献,共880例患者。Meta分析结果显示:观察组患者的治疗总有效率(OR=3.47,95%CI=2.08～5.79,P<0.000 01)和血肌酐(MD=-13.68,95%CI=-24.33～-3.02,P=0.01)、尿素氮(MD=-1.42,95%CI=-2.59～-0.24,P=0.02)、尿白蛋白排泄率(MD=-26.69,95%CI=-32.14～-21.24,P<0.000 01)、血清总胆固醇(MD=-0.58,95%CI=-0.76～-0.41,P<0.000 01)及三酰甘油(MD=-1.34,95%CI=-1.45～-1.24,P<0.000 01)等指标水平改善情况均明显优于对照组,差异均有统计学意义。结论:阿魏酸钠联合黄芪注射液治疗DN,在提高治疗总有效率和改善血液、尿液指标水平方面都有明显的效果。由于纳入研究的数量、质量有限,还有待更多数量、更高质量研究的进一步验证。

OBJECTIVE: To systematically evaluate the effectiveness of sodium ferulate combined with astragalus injection in treatment of diabetic nephropathy(DN) and its effects on the levels of blood and urine indicators. METHODS: EMBase, MEDLINE, PubMed, the Cochrane Library, CNKI, VIP and Wanfang database were retrieved to collect the RCTs of sodium ferulate combined with astragalus injection in treatment of DN(the control group was treated with routine antihypertensive, hypoglycemic, diet control and moderate exercise;while the observation group received sodium ferulate and astragalus injection on the basis of the control group), the retrieval time was from the establishment of the database to Sept. 2017. The relevant data of the included literature were extracted, and the methodological quality evaluation was carried out. The meta-analysis(Meta-analysis) of the literature was carried out using Review Manager 5.3.5 software. RESULTS: Totally 10 literature were enrolled, including 880 patients. Meta-analysis results showed that the total effective rate(OR=3.47,95%CI=2.08-5.79,P<0.000 01) and improvement of serum creatinine(MD=-13.68,95%CI=-24.33--3.02,P=0.01), urea nitrogen(MD=-1.42,95%CI=-2.59--0.24,P=0.02), urinary albumin excretion rate(MD=-26.69, 95% CI=-32.14--21.24, P <0.000 01), serum total cholesterol(MD=-0.58,95%CI=-0.76--0.41,P<0.000 01) and triacylglycerol levels(MD=-1.34,95%CI=-1.45--1.24,P<0.000 01) in the observation group were significantly better than those in the control group, and the differences were statistically significant. CONCLUSIONS: Sodium ferulate combined with astragalus injection in treatment of DN has obvious effects in improving the total effective rate and improving the levels of blood and urine indicators. Due to the limited quantity and quality of included studies, further verification of more quantity and higher quality studies is required.