益气清热活血中药治疗糖尿病肾病尿蛋白的Meta分析

目的:评价益气清热活血中药治疗糖尿病肾病(DN)尿蛋白的疗效。方法:计算机检索美国医学文摘数据库(1978—2008)、维普中文科技期刊全文数据库(1989—2009)、中国生物医学文献数据库(1990—2009)、万方中华医学会数字化期刊(1998—2008)及万方数字化期刊全文数据库(1984—2009)。收集以血管紧张素转换酶抑制剂(ACEI)或血管紧张素受体拮抗剂(ARB)为对照的益气清热活血中药治疗DN尿蛋白的随机对照试验(RCT)和半随机对照试验。两名评价员独立评价纳入试验的方法学质量,采用Revman 4.2.2软件做Meta分析。结果:纳入39篇中文RCT,全部论文被评为C级。Meta分析结果显示:ACEI或ARB基础上联合益气清热活血中药可进一步降低DN的尿微量白蛋白排泄率(WMD=-40.679,5%CI(-58.65,-22.69),P<0.00001)2、4h尿微量白蛋白量(WMD=-83.11,95%CI(-110.18,-56.04),P<0.00001)和24h尿蛋白定量(SMD=-0.70,95%CI(-0.81,-0.58),P<0.00001);单用益气清热活血中药降低尿微量白蛋白排泄率的作用可能与ACEI或ARB相似(WMD=0.599,5%CI(-42.14,43.31),P=0.98);降低24h尿微量白蛋白量(WMD=-26.86,95%CI(-40.44,-13.29),P=0.0001)和24h尿蛋白定量(SMD=-1.48,95%CI(-2.27,-0.70),P=0.0002)作用更明显。结论:益气清热活血中药治疗DN尿蛋白有一定疗效。该系统评价所纳入研究方法学上存在缺陷,证据强度不高,益气清热活血中药在降低DN尿蛋白方面的疗效仍需深入研究。

The Efficacy of Chinese Herbal Medicine Supplementing Qi,Clearing Heat and Activating Blood Circulation inthe Management of Urine Protein in Diabetic NePhroPathy:A meta-analysis

Objective:To assess the efficacy of Chinese herbal medicine suPPlementing qi,clearing heat and activating blood circulation in the management of urine Protein in diabetic nePhroPathy. Methods:Search the following database:Medline(1978-2008) ,VIP(1989-2009) ,CBM disc(1990-2009) ,CMA digital Periodicals(1998-2008) and Wanfang full-text database (1984 -2009) . Randomized or semi-randomized controlled trials (RCT) which comPared Chinese herbal medicine suPPlementing qi,clearing heat and activating blood circula...