银杏叶提取物对糖尿病肾病患者尿微量白蛋白和肾功能影响的系统评价

目的:系统评价银杏叶提取物对糖尿病肾病患者尿微量白蛋白和肾功能的影响。方法:计算机检索Pubmed医学数据库、中国生物医学文献数据库(CBM),中文科技期刊全文数据库(CNKI),维普中文数据库(VIP)和万方数据库等,以常规治疗为对照组,以在常规治疗基础上加用银杏叶提取物对糖尿病肾病患者尿微量白蛋白和肾功能影响的随机对照研究,由2位研究者按照纳入与排除标准筛选文献、提取资料和评价纳入研究的方法学质量后,采用RevMan 5.2软件进行Meta分析。结果:共纳入16项随机对照试验,1212例患者。Meta分析结果显示,与对照组相比,试验组更能减小尿白蛋白排泄率(UAER)SMD=1.00, 95%CI(0.70,1.30),P<0.01]和24 h尿蛋白定量SMD=1.00, 95%CI(0.70,1.30),P<0.01];不能显著减少血清肌酐SMD=0.11, 95%CI(-0.03,0.26),P>0.05]。结论:银杏叶提取物能显著减小糖尿病肾病患者尿微量白蛋白,但对肾功能无显著性改善。受纳入研究方法学质量限制,该结论有待大样本、高质量的RCT进一步验证。

Systemic Evaluation on Effect of Ginkgo Biloba Extract on Microalbuminuria and Renal Function in Patients with Diabetic Nephropathy

Objective: To systemically review the effect of ginkgo biloba extract (GbE) on microalbuminuria and renal function in patients with diabetic nephropathy (DN). Method: Literature were retrieved from PubMed, CNKI, VIP, CBM and Wanfang database to select the randomized controlled trials (RCT) where conventional treatment was as the control group, and GbE was also used on the basis of conventional treatment as the experimental group to study its effect on microalbuminuria and renal function in patients with diabetic nephropathy. RevMan 5.2 software was used for Meta analysis after 2 researchers selected the literature according to inclusion and exclusion criteria, extracted the data and evaluated the methodological quality in the study. Result: 16 RCTs were included, involving 1 212 patients. Meta-analysis showed that compared with control group, experimental group can significantly decrease urine albumin excretion rate (UAER)SMD=1.00, 95%CI(0.70,1.30),P<0.01]and,24-hour urinary protein quantitySMD=1.00, 95%CI (0.70, 1.30), P<0.01] and 24 h urine protein quantitationSMD=1.00, 95%CI (0.70, 1.30), P<0.01], but can not significantly decrease serum creatinine (SCr)SMD=0.11, 95%CI (-0.03, 0.26), P>0.05]. Conclusion: Ginkgo biloba extract can significantly reduce the microalbuminuria in patients with diabetic nephropathy, but has no significant improvement for renal function. Due to the restrictions of the quality of included studies, this conclusion needs to be further verified by large sample and high quality RCTs.