益气活血法治疗糖尿病肾病的Meta分析(1)
[摘要] 目的 探讨益气活血法治疗糖尿病肾病的临床疗效。 方法 检索通过检索万方期刊数据库、中国期刊全文数据库(CNKI)、中文期刊数据库(维普)，检索时间限定为建库至2018年10月，检索所有具有益气活血法治疗糖尿病肾病的随机对照试验，同时手工辅助检索相关核心期刊，追索纳入研究的参考文献。2名研究者对文献、资料进行单独筛选与提取，使用软件Rev Man 5.3作Meta分析。 结果 纳入30篇中文RCT，5篇论文评定为B级，25篇评定为C级。其中6个试验采用了随机对照试验。Meta分析结果显示：与基础治疗比较，益气活血法可显著降低尿微量蛋白排泄率[WMD=41.25，95%CI(21.25，37.56)，P<0.05];可显著提高患者临床总有效率[Z=10.25，OR=5.21，95%CI(3.45/7.25)]，差异有统计学意义(P<0.05)。 结论 益气活血法治疗糖尿病肾病疗效显著，值得推广。
[关键词] 益气活血;糖尿病;肾病
[中图分类号] R587.1 [文献标识码] A [文章编号] 1672-4062(2020)01(b)-0037-02
[Abstract] Objective To investigate the clinical efficacy of Yiqihuoxue therapy in the treatment of diabetic nephropathy. Methods Search through the retrieval of Wanfang Journal Database， China Journal Full-text Database (CNKI)， Chinese Journal Database (VIP)， the search time was limited from establishing database until October 2018， and all randomized controlled trials with Yiqihuoxue therapy for diabetic nephropathy were searched. At the same time， manual assisted retrieval of relevant core journals， retrieving references included in the study. In the two studies， the literature and data were screened and extracted separately， and the software Rev Man 5.3 was used for meta-analysis. Results 30 Chinese RCTs were included. 5 papers were rated as Grade B and 25 were rated as Grade C. 6 of the trials used randomized controlled trials. Meta-analysis results showed that compared with the basic treatment， Yiqihuoxue method can significantly reduce the micro-protein excretion rate of urine [WMD=41.25， 95% CI (21.25， 37.56)， P<0.05]; can significantly improve the clinical total effective rate of patients [Z=10.25，OR=5.21， 95%CI (3.45/7.25)]， the difference was statistically significant(P<0.05). Conclusion The effect of Yiqihuoxue therapy on diabetic nephropathy is significant and worthy of promotion.
[Key words] Yiqihuoxue; Diabetes; Kidney disease
糖尿病腎病是糖尿病患者后期常见并发症之一，发病率受饮食、生活发生因素的影响，呈上升趋势，是终末期肾脏病的主要原因之一，仅次于肾小球炎[1-2]。糖尿病肾病患者，多具有复杂代谢絮乱显现，在疾病发展至终末期肾脏病时，难以进行有效治疗，因此早期防治对延缓病情具有重要意义[3-4]。发病机制上不清楚，多认为是由多因素参与，临床治疗以药物为主，中医在治疗糖尿病肾病上，可降低不良反应，提升治疗效果[5]。该研究运用循证医学方法原理，为系统性评价益气活血法治疗糖尿病肾病的有效性，全面搜索有关益气活血法治疗糖尿病肾病的随机对照临床研究，旨在为临床治疗提供循证依据。报道如下。
1 资料与方法
1.1 一般资料
国内外刊发的采用益气活血法治疗糖尿病肾病的临床研究文献。
1.2 纳入标准
研究类型为随机对照试验;研究对象为符合公认的糖尿病肾病临床诊断或病理学诊断标准;干预措施以口服益气活血中药汤剂为主，单用或联合西药治疗;对照组为基础治疗或非中药汤剂治疗。结局指标为：24 h尿微量白蛋白量;临床疗效。
1.3 排除标准
未严格设置对照组、实验设计不严谨;中药汤剂组成不明;结局数据不全。, http://www.100md.com(郭婷婷)
[关键词] 益气活血;糖尿病;肾病
[中图分类号] R587.1 [文献标识码] A [文章编号] 1672-4062(2020)01(b)-0037-02
[Abstract] Objective To investigate the clinical efficacy of Yiqihuoxue therapy in the treatment of diabetic nephropathy. Methods Search through the retrieval of Wanfang Journal Database， China Journal Full-text Database (CNKI)， Chinese Journal Database (VIP)， the search time was limited from establishing database until October 2018， and all randomized controlled trials with Yiqihuoxue therapy for diabetic nephropathy were searched. At the same time， manual assisted retrieval of relevant core journals， retrieving references included in the study. In the two studies， the literature and data were screened and extracted separately， and the software Rev Man 5.3 was used for meta-analysis. Results 30 Chinese RCTs were included. 5 papers were rated as Grade B and 25 were rated as Grade C. 6 of the trials used randomized controlled trials. Meta-analysis results showed that compared with the basic treatment， Yiqihuoxue method can significantly reduce the micro-protein excretion rate of urine [WMD=41.25， 95% CI (21.25， 37.56)， P<0.05]; can significantly improve the clinical total effective rate of patients [Z=10.25，OR=5.21， 95%CI (3.45/7.25)]， the difference was statistically significant(P<0.05). Conclusion The effect of Yiqihuoxue therapy on diabetic nephropathy is significant and worthy of promotion.
[Key words] Yiqihuoxue; Diabetes; Kidney disease
糖尿病腎病是糖尿病患者后期常见并发症之一，发病率受饮食、生活发生因素的影响，呈上升趋势，是终末期肾脏病的主要原因之一，仅次于肾小球炎[1-2]。糖尿病肾病患者，多具有复杂代谢絮乱显现，在疾病发展至终末期肾脏病时，难以进行有效治疗，因此早期防治对延缓病情具有重要意义[3-4]。发病机制上不清楚，多认为是由多因素参与，临床治疗以药物为主，中医在治疗糖尿病肾病上，可降低不良反应，提升治疗效果[5]。该研究运用循证医学方法原理，为系统性评价益气活血法治疗糖尿病肾病的有效性，全面搜索有关益气活血法治疗糖尿病肾病的随机对照临床研究，旨在为临床治疗提供循证依据。报道如下。
1 资料与方法
1.1 一般资料
国内外刊发的采用益气活血法治疗糖尿病肾病的临床研究文献。
1.2 纳入标准
研究类型为随机对照试验;研究对象为符合公认的糖尿病肾病临床诊断或病理学诊断标准;干预措施以口服益气活血中药汤剂为主，单用或联合西药治疗;对照组为基础治疗或非中药汤剂治疗。结局指标为：24 h尿微量白蛋白量;临床疗效。
1.3 排除标准
未严格设置对照组、实验设计不严谨;中药汤剂组成不明;结局数据不全。, http://www.100md.com(郭婷婷)
参见：首页 > 医疗版 > 疾病专题 > 肾脏内科 > 继发性肾脏疾病 > 糖尿病肾病