黄葵胶囊联合ACEI/ARB治疗糖尿病肾病的meta分析

A meta-analysis of Huangkui capsules Combined with ACEI/ARB in treatment of diabetic kidney disease

目的对黄葵胶囊治疗糖尿病肾病(DKD)的效果进行meta分析。方法计算机检索中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)、维普期刊数据库(VIP)、万方数据库、PubMed、Embase、Cochrane Library、Web of Science,检索黄葵胶囊联合血管紧张素转换酶抑制剂/血管紧张素Ⅱ受体拮抗剂(ACEI/ARB)(试验组)对比单用ACEI/ARB(对照组)治疗DKD的随机对照试验,由2位研究者独立进行筛选、提取资料及质量评价后,通过Revman 5.3软件进行meta分析。结果共纳入11项研究,共计患者997例。与对照组比较,试验组能降低DKD患者尿微量清蛋白排泄率(UAER)[均数差(MD)=-23.25,95%可信区间(95%CI)(-27.04,-19.46),P<0.05]和降低血尿素氮(BUN)[MD=-0.22,95%CI(-0.43,-0.01),P<0.05];但在降低血肌酐(Scr)水平方面,试验组治疗效果与对照组比较,差异无统计学意义[MD=-0.81,95%CI(-3.48,1.86),P>0.05]。结论黄葵胶囊联合ACEI/ARB类药物比单用ACEI/ARB类药物更能降低DKD患者的UAER水平,但在改善患者肾功能方面仍需要继续研究。

Objective To Meta-analysis of Huangkui capsulesin treatment of diabetic kidney disease(DKD).Methods Retrieved from China Biomedical Literature Database(CBM),China Journal Full-Text Database(CNKI),VIP Periodical Database(VIP),Wanfang Database,PubMed,Embase,Cochrane Library,Web of Science randomized controlled trials about Abelmoschus Manihot with ACEI/ARB(test group)versus ACEI/ARB alone(control group)in the treatment of DKD were collected.After selection、data extraction and quality evaluation by two researchers independently,meta-analysis was performed by using Revman 5.3 software.Results A total of 11 studies were included,involving 997 patients.Results of Meta analysis showed that compared with control group,test group could decrease the 24h urine albumin excretion rate(UAER)[MD=-23.25,95%CI(-27.04,-19.46),P<0.05]and urea nitrogen(BUN)[MD=-0.22,95%CI(-0.43,-0.01),P<0.05].However,in terms of reducing serum creatinine(Scr)levels,the treatment effect of the experimental group was not significantly different from that of the control group[MD=-0.81,95%CI(-3.48,1.86),P>0.05].Conclusion Huangkui capsule combined with ACEI/ARB drugs can reduce UAER in patients with DKD compared with ACEI/ARB drugs alone,but the renal function improved need to further research.