当归补血汤治疗糖尿病肾病的Meta分析

A Systematic Evaluation and Meta-analysis of Danggui Buxue Decoction in the Treatment of Diabetic Nephropathy

目的:评价当归补血汤及其加减方治疗糖尿病肾病的有效性与安全性。方法:检索中国期刊全文数据库、万方医学数据库、中文科技期刊数据库、PubMed、Embase等数据库,筛选随机对照试验(RCTs),时间为建库至2020年2月。采用RevMan 5.3软件对纳入的研究进行Meta分析,Cochrane系统评价工具评价纳入文献的质量。结果:共纳入9篇RCTs,Meta分析结果显示:2组总有效率比较,RR=1.25,95%CI为1.17~1.33,Z=6.70,P<0.01;24 h尿蛋白定量比较,MD=-70.07,95%CI为-77.05~-63.06,Z=19.63,P<0.01;2组血肌酐清除率比较,SMD=-0.60,95%CI为-0.88~-0.32,Z=4.17,P<0.01;2组同型半胱氨酸比较,SMD=-2.84,95%CI为-3.12~-2.57,Z=20.21,P<0.01。结论:当归补血汤及其加减方治疗糖尿病肾病可有效提高患者的总有效率,改善患者肾功能情况,降低同型半胱氨酸水平,提高患者生命质量。

Objective:To evaluate the efficacy and safety of Danggui Buxue Decoction and its modified prescription in the treatment of diabetic nephropathy.Methods:Randomized Controlled Tests(RCTs)from the database establishment to February 2020 were screened from CNKI,VIP,wanfang,PubMed,Embase and other databases.The RevMan 5.3 software was used for meta-analysis of the included studies,and the Cochrane systematic review tool was used to evaluate the quality of the included literature.Results:A total of 9 RCTs were included,and the results of meta-analysis showed the comparison of the total effective rate[RR=1.25,95%CI=(1.17 to 1.33),Z=6.70 P<0.01],comparison of 24-hour urine protein quantification:[MD=-70.07,95%CI=(-77.05 to-63.06),Z=19.63 P<0.01],comparison of blood creatinine clearance:[SMD=-0.60,95%CI=(-0.88 to-0.32),Z=4.17,P<0.01],and the contrast of homocysteine:[SMD=-2.84,95%CI=(-3.12 to-2.57),Z=20.21,P<0.01].Conclusion:Danggui Buxue Decoction and its modified prescription can effectively improve the total effective rate of patients with diabetic nephropathy,improve the renal function of patients,reduce the level of homocysteine,and improve the quality of life of patients.However,the quality of the included literature is low and there is a certain publication bias,which requires more large samples and high-quality research verification.