海南医科大学学报

目的:通过meta分析系统评价肾衰宁颗粒联合西医治疗糖尿病肾脏病的有效性及安全性。方法:计算机检索CNKI、WanFang Data、VIP、CBM、The Cochrane、Embase、PubMed等数据库中肾衰宁颗粒治疗糖尿病肾脏病的随机对照试验,检索时间为各数据库建库至2020年5月。纳入符合标准的文献后对其进行基本特征资料的提取,采用Cochrane Handbook评价标准对纳入文献进行质量评价,并采用Revman5.3软件进行meta分析。结果:最终纳入文献9篇,892例患者,其中试验组446例,对照组446例。Meta分析结果显示,试验组总有效率比对照组更高[RR=1.26,95%CI(1.17,1.37),P<0.000 01],且能进一步降低血清尿素氮[MD=-1.65,95%CI(-2.53,-0.77),P=0.000 2]、24 h尿白蛋白排泄率[SMD=-4.21,95%CI(-6.23,-2.19),P<0.000 1]、血肌酐[MD=-21.50,95%CI(-28.49,-14.50),P<0.000 01]及胱抑素C[MD=-1.34,95%CI(-2.08,-0.60),P=0.000 4],但对降低空腹血糖方面,两组差异无统计学意义[MD=-0.46,95%CI(-1.18,0.27),P=0.22]。结论:肾衰宁颗粒联合西医疗法在提高糖尿病肾脏病患者肾小球滤过率,减轻肾损伤,保护肾功能方面效果更好,且不良反应发生率低,症状较轻,具有安全性。

Objective:To systematically evaluate the efficacy and safety of Shenshuaining granule combined with Western medicine treatment for diabetic kidney disease(DKD)by meta analysis.Methods:Databases including CNKI,WanFang Data,VIP,CBM,The Cochrane,Embase and PubMed were electronically searched from inception to May 2020 to collect randomized controlled trials of Shenshuaining granule with Western medicine treatment for diabetic nephropathy.The trial was screened based on inclusion and exclusion criteria,and the methodological quality of the included relevant trial was assessed by Cochrane Handbook.Meta-analysis was then performed by Revman 5.3 software.Results:A total of 9 studies involving 892 patients were included with 446 patients in the experimental group and 446 patients in the control group.The result of meta-analysis showed that the experimental group treated with Shenshuaining granule combined with Western medicine significantly improved the total effective rate of DKD:[RR=1.26,95%CI(1.17,1.37),P<0.000 01],and further reduced serum urea nitrogen[MD=-1.65,95%CI（-2.53,-0.77）,P=0.000 2],24 h urine albumin excretion rate[SMD=-4.21,95%CI（-6.23,-2.19）,P<0.000 1],serum creatinine[MD=-21.50,95%CI（-28.49,-14.50）,P<0.000 01]and cystatin C[MD=-1.34,95%CI（-2.08,-0.60）,P=0.000 4].However,the difference in fasting blood glucose between the two groups was not statistically significant[MD=-0.46,95%CI（-1.18,0.27）,P=0.22].Conclusion:Shenshuaining granule combined with Western medicine treatment can improve the rate of renal pellet filtration in patients with DKD,reduce kidney injury and protect kidney function with low incidence rate of side effects and high safefy.