中西医结合治疗肾性血尿Meta分析

Meta-Analysis of Renal Hematuria Treated by Combination of Traditional Chinese and Western Medicine

目的:通过Meta分析的方法系统评价中西医结合治疗肾性血尿的有效性。方法:计算机综合检索中国知网(CNKI)、万方数据知识服务平台(Wanfang)、维普中文期刊(VIP)、中国生物医学文献服务系统(CBM)、PubMed、Web of Science等国内外数据库,收集建库至2022年1月有关中西医结合治疗肾性血尿相关的随机对照试验。由2名研究员依据纳入和排除标准进行筛选文献,依据Cochrane系统评价方法进行文献质量评价,采用RevMan 5.3软件进行结局指标分析。结果:入选21项研究,涉及1760名肾性血尿患者。Meta分析结果显示:在西医常规治疗基础上联合中医药治疗可进一步降低尿红细胞数(Z = 4.34, MD = −7.88 [−11.44, −4.32], P < 0.00001;Z = 4.96, MD = −5.36 [−7.48, −3.24], P < 0.00001)、尿蛋白定量(24 h) (Z = 7.63, MD = −0.36 [−0.46, −0.27], P < 0.00001)、血肌酐(Z = 4.52, MD = −13.28 [−19.04, −7.52], P < 0.00001)、尿素氮(Z = 4.40, MD = −1.97 [−2.84, −1.09], P < 0.0001)。结论:中西医结合治疗肾性血尿相较于纯西药治疗具有一定的临床优势,但未来仍然需要更大样本量、设计更加完善、质量更高的临床研究来进一步论证本次结论。

Objective: Systematic evaluation of the efficacy of integrated traditional Chinese and western medicine in the treatment of renal hematuria by Meta analysis. Methods: The computer comprehensively searched the domestic and foreign databases such as CNKI, Wanfang Data, VIP, CBM and Web of Science, and collected the randomized controlled trials related to integrated traditional Chinese and western medicine (since the establishment of the databases to January 2022). Literature was screened according to inclusion and exclusion criteria by two researchers, literature quality was evaluated according to Cochrane systematic review method, and outcome indicators were analyzed using RevMan 5.3 software. Results: 21 RCTs were finally included, a total of 1760 patients with renal hematuria. The results of Meta analysis show that on the basis of routine treatment of western medicine combined with traditional Chinese medicine could further reduce the number of urinary red blood cells (Z = 4.34, MD = −7.88 [−11.44, −4.32], P < 0.00001;Z = 4.96, MD = −5.36 [−7.48, −3.24], P < 0.00001), 24 h urine protein (Z = 7.63, MD = −0.36 [−0.46, −0.27], P < 0.00001), serum creatinine (Z = 4.52, MD = −13.28 [−19.04, −7.52], P < 0.00001), urea nitrogen (Z = 4.40, MD = −1.97 [−2.84, −1.09], P < 0.0001). Conclusion: The combination of traditional Chinese and western medicine in the treatment of renal hematuria has certain clinical advantages compared with pure western medicine, but clinical studies with larger sample size, better design and higher quality are still needed in the future to further demonstrate this conclusion.