维生素E治疗糖尿病肾病临床研究的Meta分析

Meta Analysis of Clinical Study on Vitamin E in the Treatment of Diabetes Nephropathy

目的:对维生素E治疗糖尿病肾病(DKD)的有效性进行系统评价。方法:电子检索PubMed、Web of Science、Cochrane Library等外文数据库及中国知识基础设施工程(CNKI)、万方数据知识服务平台(Wan Fang Data)、维普期刊资源整合服务平台(VIP)、中国生物医学文献服务系统(SinoMed)等中文数据库,时间截至2021年4月31日。按照Cochrane手册推荐的质量评价标准对纳入研究进行质量学评价,采用Rev Man 5.3软件进行数据分析。结果:共纳入8篇随机对照试验(RCTs),涉及到552例DKD患者。结果显示维生素E治疗组与对照组相比,在血清生化水平上,显著改善了24 h尿蛋白[MD=-47.31,95%CI(-50.8,-43.81),P<0.00001]、血肌酐[MD=-11.10,95%CI(-12.78,-9.41),P<0.00001]、糖化血红蛋白[MD=-0.14,95%CI(-0.23,-0.05),P=0.002]、总胆固醇[MD=-0.27,95%CI(0.36,-0.18),P<0.00001],差异具有统计学意义;但在改善肾小球滤过率、尿素、血糖、三酰甘油等水平上差异无明显统计学意义(P>0.05)。结论:维生素E在糖尿病肾病的治疗中有良好疗效,但仍需要高质量证据予以验证。

Objective:To systematically evaluate the effectiveness of vitamin E in the treatment of diabetic nephropathy(DKD).Methods:Electronic retrieval of foreign language databases such as PubMed,Web of Science,Cochrane Library and China Knowledge Infrastructure Engineering(CNKI),Wan Fang Data Knowledge Service Platform(Wan Fang Data),Weipu Journal Resource Integration Service Platform(VIP),China Biomedicine Chinese databases such as the Document Service System(SinoMed),as of April 31,2021.The included studies were qualitatively evaluated according to the quality evaluation standards recommended by the Cochrane Handbook,and Rev Man 5.3 software was used for data analysis.Results:A total of 8 randomized controlled trials(RCTs)were included,involving 552 patients with DKD.The results showed that compared with the control group,the vitamin E treatment group significantly improved the 24-hour urine protein[MD=-47.31,95%CI(-50.8,-43.81),P<0.00001],serum creatinine[MD=-11.10,95%CI(-12.78,-9.41),P<0.00001],glycosylated hemoglobin[MD=-0.14,95%CI(-0.23,-0.05),P=0.002],total cholesterol[MD=-0.27,95%CI(0.36,-0.18),P<0.00001],the difference is statistically significant;but there is no significant difference in improving glomerular filtration rate,urea,blood sugar,triglycerides,etc.(P>0.05).Conclusion:Vitamin E has a good effect in the treatment of diabetic nephropathy,but it still needs high-quality evidence to verify it.