尿毒清颗粒对腹膜透析患者临床疗效及安全性的系统评价与Meta分析

Efficacy and Safety of Uremic Clearancegranule in Patients with Peritoneal Dialysis:A Systematic Evaluation and Meta-analysis

目的系统评价尿毒清颗粒治疗腹膜透析患者临床疗效及安全性。方法计算机检索中国知网数据库(CNKI)、万方数据库、重庆维普全文数据库(VIP)、Sinomed(原CBM)、Pub Med、The Cochrane Library、Embase等数据库中含尿毒清颗粒对腹膜透析患者的临床文献,并辅以手工检索。检索时限为建库之日起至2018年10月。由2名研究员依据预设纳入和排除标准进行质量评价、数据资料提取,采用Cochrane协作网提供的Rev Man 5. 3软件进行Meta分析。结果纳入12篇文献,共829例患者,其中试验组416例,对照组413例。Meta分析结果显示,与对照组相比,尿毒清颗粒能升高尿素清除指数(KT/V)[MD=0. 18,95%CI(0. 10,0. 26)],升高腹透液肌酐(Ccr)[MD=10. 03,95%CI(7. 47,12. 58)],降低超敏C反应蛋白(hs-CRP)[MD=-2. 24,95%CI(-3. 14,-1. 33)],降低白细胞介素-6(IL-6)[MD=-5. 72,95%CI(-7. 36,-4. 08)],降低血清血管内皮生长因子活性(血清VEGF)[SMD=-0. 76,95%CI(-1. 02,-0. 5)]。结论与对照组相比,尿毒清颗粒能明显升高KT/V、Ccr,降低hs-CRP、IL-6、血清VEGF。由于所纳入的文献数量少,其研究方法学质量较低,仍需更多高质量的相关研究进一步验证。

Objective To evaluate the clinical effect and safety of uremic clearancegranule for the treatment of peritoneal dialysis patients.Methods We searched the databases of CNKI,Wanfang,VIP,Sinomed,PubMed,the Cochrane Library,Embase and other databases for clinical literature concerning urinary dialysis on peritoneal dialysis patients.The search period is from the date of establishment to October,2018.Two investigators evaluated the quality and extracted the data according to the pre-set inclusion and exclusion criteria,followed by Meta-analysis using RevMan 5.3 software provided by the Cochrane Collaboration.Results A total of 12 RCTs were obtained,including 829 patients,experimental group 416 patients vs control group 413 patients.Meta analysis indicated that uremic clearancegranule treatment gave better results in increasing urea clearance index(KT/V)[MD=0.18,95%CI(0.10,0.26)],peritoneal creatinine(Ccr)[MD=10.03,95%CI(7.47,12.58)],and also lowering hypersensitive C-reactive protein(hs-CRP)[MD=-2.24,95%CI(-3.14,-1.33)],Interleukin-6(IL-6)[MD=-5.72,95%CI was(-7.36,-4.08)],serum vascular endothelial growth factor activity(serum VEGF)[SMD=-0.76,95%CI(-1.02,-0.5)].Conclusion Compared with the control group,uremic clearancegranule can significantly improve KT/V,Ccr,reduce hs-CRP,IL-6 and serum VEGF.Due to the small number of literature included,the research methods have low quality of evidence,further high-quality related researches are still needed to further verify.