丹参川芎嗪注射液联合前列地尔治疗糖尿病肾病的Meta分析

Meta-analysis of Salvia Miltiorrhiza Ligustrazine Injection Combined with Alprostadil in the Treatment of Diabetic Nephropathy

目的:系统评价丹参川芎嗪注射液联合前列地尔治疗糖尿病肾病的有效性和安全性。方法:计算机检索Pub Med、EM-Base、The Cochrane Library、中国知网(CNKI)、万方资源数据库和维普中文科技期刊数据库从建库至2019年8月丹参川芎嗪注射液联合前列地尔治疗糖尿病肾病的随机对照试验研究,根据纳入与排除标准对文献进行筛选,并应用Review Manager5.3统计学软件进行数据分析。结果:最终纳入13篇文献,合计882例患者,其中治疗组(丹参川芎嗪注射液联合前列地尔)和对照组(单用丹参川芎嗪注射液或前列地尔)各441例,Meta分析结果显示,治疗组在提高总有效率[RR=1.21,95%CI(1.10,1.32),P<0.0001],降低尿微量白蛋白[MD=-10.03,95%CI(-11.82,-8.24)P<0.00001]、24h尿微量白蛋白定量[MD=-49,95%CI(-60.60,-37.39)P<0.00001]、血肌酐[MD=-18.22,95%CI(-29.51,-6.949)P=0.002]、尿素氮[MD=-2.98,95%CI(-5.11,-0.84)P=0.006]方面优于对照组,不良反应发生率[RR=1.60,95%CI(0.76,3.39),P=0.22]比较无统计学意义。结论:丹参川芎嗪注射液联合前列地尔治疗糖尿病肾病疗效显著,两者联合应用的临床疗效优于单独用药,但因本研究纳入的质量偏低、样本量少,尚需更多高质量、大样本的临床研究加以验证。

Objective:To systematically evaluate the efficacy and safety of Danshen Ligustrazine Injection combined with alprostadil in the treatment of diabetic nephropathy.Methods:Computer search Pub Med,EM-Base,The Cochrane Library,China Knowledge Network(CNKI),Wanfang Resource Database and Weipu Chinese Science and Technology Periodical Database from the establishment of the library to August 2019 Salvia miltiorrhiza injection combined with alprostadil treatment In a randomized controlled trial study of diabetic nephropathy,the literature was screened according to inclusion and exclusion criteria,and data analysis was performed using Review Manager5.3 statistical software.Results:13 articles were finally included,a total of 882 patients,including 441 patients in the treatment group(Danshen Ligustrazine injection combined with alprostadil)and the control group(Danshen Ligustrazine injection or alprostadil),Meta analysis results It was shown that the treatment group was improving the total effective rate[RR=1.21,95%CI(1.10,1.32),P<0.0001],and decreasing urine microalbumin[MD=-10.03,95%CI(-11.82,-8.24)P<0.00001],24h urine microalbumin quantitation[MD=-49,95%CI(-60.60,-37.39)P<0.00001],blood creatinine[MD=-18.22,95%CI(-29.51,-6.949)P=0.002],urea nitrogen[MD=-2.98,95%CI(-5.11,-0.84)P=0.006]is superior to the control group,the incidence of adverse reactions[RR=1.60,95%CI(0.76,3.39),P=0.22]There is no statistical significance.Conclusion:Salvia miltiorrhizae injection combined with alprostadil is effective in the treatment of diabetic nephropathy.The clinical effect of the combination of the two is better than the drug alone.However,due to the low quality and small sample size included in this study,more high-quality,Large sample of clinical studies to verify.