银杏达莫注射液治疗早期糖尿病肾病的系统评价

目的:系统评价银杏达莫注射液治疗早期糖尿病肾病(DN)的疗效与安全性。方法:采用Cochrane系统评价方法,计算机检索Medline、维普(VIP)、中国知网(CNKI)、万方数据库和PubMed数据库,对数据用RevMan5.0软件进行Meta分析。结果:共纳入16项研究,包括1214例患者。Meta分析结果显示,治疗组在降低早期DN患者24h尿微量白蛋白[WMD=-28.14,95%CI(-33.94,-22.35),P<0.00001]、甘油三酯[WMD=-1.63,95%CI(-2.43,-0.84),P<0.0001]、24h尿白蛋白排泄率[WMD=-34.89,95%CI(-47.83,-21.96),P<0.00001]、全血黏度[WMD=-2.12,95%C(I-3.59,-0.66),P=0.005]、血浆黏度[WMD=-0.61,95%CI(-1.07,-0.14),P=0.01]以及纤维蛋白原[WMD=-0.91,95%CI(-1.38,-0.44),P=0.0001]方面均优于对照组;在改善早期DN患者血清肌酐[WMD=2.96,95%CI(-23.07,28.99),P=0.82]、尿素氮[WMD=-0.23,95%CI(-0.67,0.21),P=0.31]、总胆固醇[WMD=-0.47,95%CI(-1.00,0.05),P=0.08]、空腹血糖[WMD=-0.32,95%CI(-0.79,0.14),P=0.17]及餐后2h血糖[WMD=-0.18,95%CI(-0.92,0.55),P=0.63]方面与对照组相似。结论:银杏达莫注射液治疗早期DN有一定疗效且相对安全,今后有必要开展高质量的多中心、大样本、随机、双盲临床试验进一步验证。

Yinxing Damo Injection in the Treatment of Early Diabetic Nephropathy:A Systematic Review

OBJECTIVE:To evalute the effectiveness and safety of Yinxing damo injection in the treatment of early diabetic nephropathy(DN).METHODS:Medline,VIP,CNKI,Wanfang database and PubMed were searched and performed Meta-analysis using Cochrane Collaboration’s Rev Man 5.0 software.RESULTS:16 RCTs were enrolled,involving 1 214 patients.Results of Meta-analysis showed 24 h urinary protein[WMD=-28.14,95%CI(-33.94,-22.35),P<0.000 01],TG[WMD=-1.63,95% C(I-2.43,-0.84),P<0.000 1],24 h UAER[WMD=-34.89,95%C(I-47.83,-21.96),P<0.000 01],whole blood viscosity [WMD=-2.12,95%C(I-3.59,-0.66),P=0.005],plasma viscosity[WMD=-0.61,95%CI(-1.07,-0.14),P=0.01]and fibrinogen blood[WMD=-0.91,95%CI(-1.38,-0.44),P=0.000 1]of treatment group were better than conventional treat-ment group;the improvement of Scr[WMD=2.96,95%CI(-23.07,28.99),P=0.82],BUN[WMD=-0.23,95%C(I-0.67,0.21),P=0.31],TC[WMD=-0.47,95%CI(-1.00,0.05),P=0.08],FBG[WMD=-0.32,95%C(I-0.79,0.14),P=0.17]and 2 h PBG[WMD=-0.18,95%C(I-0.92,0.55),P=0.63]of treatment were similar to those of conventional treatment group.CONCLU-SION:Yinxing damo injection is relatively safe and effective in the treatment of early diabetic nephropathy.However,randomized,double-blind,multi-center and large-scale samples of clinical trials are required for further investigations.