真武汤治疗糖尿病肾病的系统评价研究

目的：系统评价真武汤治疗糖尿病肾病的疗效及安全性。方法：电子检索CNKI、万方、CBM、维普等数据库（检索期限为各数据库建库至2013年9月）。运用Cochrane系统评价员手册5.2版的评估标准和GRADE标准,评估纳入研究的质量,用RevMan5.2软件进行统计学分析。结果：共纳入10个随机对照试验,包括703例患者,各研究样本量30～136例。因对照组采用方法不同,所以将研究分为3个亚组。但方法学质量评价显示纳入研究文献质量不高,均为低级和极低级证据。Meta分析显示,真武汤对糖尿病肾病治疗总有效率、减少24h尿蛋白定量、血清肌酐,中医症候积分方面与西药相当;个别研究显示真武汤优于西药。结论：目前真武汤治疗糖尿病肾病的疗效证据仍十分有限,尚需高质量的研究以增加证据强度。

Investigation on Systematic Review of Zhenwu Decoction for Diabetic Nephropathy

Objective ： To review the curative effect and safety of Zhenwu Decoction in treatment of diabetic nephropa- thy. Methods ：The retrieval strategy was as follows ：CNKI, Wanfang, CBM, VIP and so on were retrieved （since each data- base built to 2013.9 ）. The quality of included studies was evaluated by Cochrane review＇s manual version 5.2 of the evaluation criteria and GRADE evaluation, and Meta - analysis was conducted with Rev Man 5.2 software. Results ： A total of 10 included studies were all randomized controlled trials, including 703 patients, and the sample size of each study was from 30 to 136 cases. Because control drugs used in studies were different from each other and the included studies can be divided into 3 subgroups. While methodological quality assessment showed that the quality of the including studies was not high, all low and very low instead. Meta - analysis showed that the effects of Zhenwu Decoction on cure rate, total effective rate and decrease of 24 h urinary protein, Scr and symptom scores were similar to those of western medicine. A few studies showed the effect of Zhenwu Decoction was much better. Conclusion： Evidence of Zhenwu Decoction effects in treating diabetic nephropathy is quite limited,which has to be strengthened by more studies of high quality.