摘要
目的 系统评价黄芪注射液联合血管紧张素转换酶抑制(angiotensin-converting enzyme inhibitors,ACEI)或血管紧张素Ⅱ受体拮抗剂(angiotensin II receptor blocker,ARB)治疗早期糖尿病肾病的临床疗效。方法 检索EMBASE、PubMed、The Cochrane Central Register of Controlled Trials、Web of Science数据库、中国知网数据库、中国科技期刊数据库(维普)、万方数据知识服务平台,收集建库至2021年11月国内外公开发表的关于黄芪注射液联合ACEI或ARB治疗早期糖尿病的相关文献;按照偏倚评估工具2.0版本进行纳入研究的质量评价;采用RevMan5.3软件和STATA 12.0软件进行meta分析。结果 检索相关文献1 379篇,按照纳入和排除标准共筛选出18篇符合要求的研究文献,共纳入2 056例早期糖尿病肾病患者,其中试验组(黄芪注射液联合ACEI或ARB治疗)678例,对照组(采用ACEI或ARB常规治疗)663例。meta分析结果显示,使用黄芪注射液联合治疗组患者的临床有效率高于对照组(OR=4.16,95%CI=2.05~8.42);血尿素氮水平低于对照组(MD=–0.73,95%CI=–1.30~–0.15);尿白蛋白排泄率低于对照组(SMD=–1.90,95%CI=–2.38~–1.42);血肌酐水平低于对照组(MD=–6.61,95%CI=–11.28~–1.94)。结论 黄芪注射液能够显著提高早期糖尿病肾病患者的临床总有效率、降低尿白蛋白排泄率、肌酐、尿素氮指标。
Objective To systematically review clinical efficacy of milk vetch(Astragalus sinicus L.) injection combined with angiotensin-converting enzyme inhibitors(ACEI) or angiotensin II receptor blocker(ARB) in early diabetic nephropathy treatment. Methods We retrieved literatures published at home and abroad up to November 2021 on clinical effect of milk vetch injection combined with ACEI or ARB in the treatment of early diabetic nephropathy through searching EMBASE, PubMed, the Cochrane Central Register of Controlled Trials, Web of Science database, China National Knowledge Infrastructure(CNKI), China Science and Technology Periodical Database(VIP), and Wanfang Data Knowledge Service Platform. The Bias Assessment Tool Version 2.0 was used to evaluate the quality of studies included;meta-analysis was performed using RevMan 5.3 and STATA 12.0 software. Results From 18 eligible studies finally screened out according to the inclusion and exclusion criteria, totally 2 056 early diabetic nephropathy patients were pooled in the meta analysis and of the patients, 678 had treatment of milk vetch injection combined with ACEI or ARB and 663 had routine treatment of ACEI or ARB. The results of the meta analysis showed that the clinically effective rate of milk vetch injection plus ACEI/ARB treatment was significantly higher than that of ACEI or ARB treatment(odds ratio [OR] = 4.16, 95%confidence interval [95% CI]: 2.05 – 8.42);compared with those with ACEI or ARB treatment, the patients with milk vetch injection plus ACEI/ARB treatment had significantly lower blood urea nitrogen(mean difference [MD] = – 0.73, 95% CI:– 1.30 – – 0.15), urinary albumin excretion rate(standardized mean difference [SMD] = – 1.90, 95% CI: – 2.38 – – 1.42) and serum creatinine(MD = – 6.61, 95% CI : – 11.28 – – 1.94). Conclusion Milk vetch injection combined with ACEI or ARB can improve overall clinical treatment efficacy and reduce urinary albumin excertion ratio, creatinine and urea nitrogen in patients with early diabetic nephropathy.
作者
宗晓郁
周锦
张东强
郑征
李慧
王萌萌
范正悦
李慧杰
陈俊儒
宫建
ZONG Xiao-yu;ZHOU Jin;ZHANG Dong-qiang(Research Group of Pharmacoepidemiology and Clinical Drug Evaluation,Shenyang Pharmaceutical University,Shenyang,Liaoning Province 110016,China)
出处
《中国公共卫生》
CAS
CSCD
北大核心
2022年第9期1219-1223,共5页
Chinese Journal of Public Health
关键词
黄芪
糖尿病肾病
META分析
milk vetch
early diabetic nephropathy
meta-analysis
