尿毒清颗粒联合血管紧张素系统阻滞剂治疗糖尿病肾病的Meta分析

目的:系统评价尿毒清颗粒联合RAAS系统阻滞剂治疗糖尿病肾病的疗效。方法:运用计算机检索CNKI、万方、VIP、Pubmed、Embase及Cochrane Library中关于尿毒清颗粒联合RAAS系统阻滞剂治疗糖尿病肾病随机对照试验(RCT)的研究文献。采用RevMan5.3软件对符合本次研究的文献中所需要的数据进行Meta分析。结果:最终收入15篇随机对照试验,共1063例患者纳入分析,其中联合治疗538例,对照组525例。Meta分析结果显示尿毒清颗粒联合RAAS系统阻滞剂组在临床缓解率OR=2.92,95%CI(1.76-4.86)]、24 h尿蛋白定量MD 0.71,95%CI(0.28-1.14)]、UAERMD 41.13,95%CI(26.66-55.59)]。但尿毒清颗粒联合RAAS系统阻滞剂观察组在降低血清尿素氮MD-0.86,95%CI(0.05-1.68,P=0.02)]、降低空腹血糖MD-0.03,95%CI(-0.15-0.09),P=0.61]方面无治疗优势。2组不良事件发生率差异无统计学意义RR=2.34,95%CI(0.69-7.95),P=0.17]。结论:尿毒清颗粒联合RAAS系统阻滞剂可能与单独使用RAAS系统阻滞剂一样安全,在提高总有效率、降低24 h尿蛋白定量及UAER方面具有优势。但由于此次纳入分析的文献质量偏低,未来更需要多中心,大样本,研究设计更严谨的随机双盲实验做进一步验证。

Meta-analysis of Niaoduqing Granules Combined with ACEI/ARB in the Treatment of Diabetic Nephropathy

To systematically evaluate the efficacy of Niaoduqing Granules combined with ACEI/ARB in the treatment of diabetic nephropathy.Methods:Computer-researched literature on diabetic nephropathy randomized controlled trials ( RCT ) in the treatment of Niaoduqing Granules combined with ACEI/ARB was screened in CNKI,Wanfang,VIP,Pubmed,Embase,and Cochrane Library.A Meta-analysis of the data required in the literature in accordance with this study was performed using revman 5.3 software.Results:A total of 15 randomized controlled trials were finally analyzed and 1 063 patients were adopted for analysis,including 538 patients receiving the combination treatment and 525 patients in the control group.The results of Meta-analysis showed that the clinical remission rate of Niaoduqing Granule combined with ACEI/ARB was significantly better than of the control group OR=2.92,95% CI ( 1.76-4.86 )].The treatment combined with Niaoduqing granule decreased the 24-hour urinary protein quantitation MD 0.71,95% CI ( 0.28-1.14 )] and UAER MD 41.13,95% CI ( 26.66-55.59 )] levels.However,the combination group had no treatment advantage on reducing serum urea nitrogen MD 0.86,95% CI ( 0.05-1.68 ),P=0.02] and fasting blood glucose ( MD-0.03,95% CI (-0.15-0.09 ),P=0.61].And there was no significance in adverse events between 2 groups RR=2.34,95% CI ( 0.69-7.95 ),P=0.17].Conclusion:Niaoduqing Granules-ACEI/ARB combination group maybe as safe as using ACEI/ARB alone,and the combination had an advantage in improvement in total effective rate,reducing of 24-hour urinary protein quantitation and UAER.However,due to the low quality of the literature included in this analysis,more centers and large samples are needed in the future.A more rigorous randomized double-blind trial was designed for further validation.