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六味地黄丸类方中药复方治疗糖尿病肾病蛋白尿临床疗效的Meta分析

A Meta-Analysis of the Clinical Efficacy of TCM Decoctions Made from Formulas in the Liuwei Dihuang Wan Categorized Formulas in Treating Diabetic Nephropathy Proteinuria.

作者信息

Gao Xue, Shang Jianwei, Liu Hongfang, Yu Borui

机构信息

Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China.

Beijing University of Chinese Medicine, Beijing 100029, China.

出版信息

Evid Based Complement Alternat Med. 2018 Sep 26;2018:2427301. doi: 10.1155/2018/2427301. eCollection 2018.

DOI:10.1155/2018/2427301
PMID:30356440
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6178512/
Abstract

OBJECTIVE

Diabetic nephropathy (DN) is one of the microvascular complications of diabetes mellitus. Proteinuria is the most important clinical characteristics of DN and an independent risk factor for disease progression of DN; reducing urine protein is the primary target of treatment strategies for DN. Liuwei Dihuang Wan Categorized Formulas (LDWCFs), a group of classic traditional Chinese medicine (TCM) formulas aiming at "kidney -tonifying", have been widely used in the treatment of DN. This study aimed to obtain a comprehensive understanding of the TCM method "kidney-tonifying" in the treatment of DN by conducting a meta-analysis to analyze the clinical efficacy of decoctions made from the LDWCFs in the treatment of DN proteinuria.

METHODS

CNKI, Wanfang, Weipu, CBM, PubMed, Embase, and the Cochrane Library were searched; 14 studies were included in the meta-analysis.

RESULTS

The results showed that the overall efficacy of the LDWCFs in treating DN was significantly better than that of the comparators (OR 2.87, 95% CI 1.98-4.15, <0.00001). These formulas showed better efficacy than the comparators in reducing 24-hour urinary protein level (MD 0.12, 95% CI 0.06-0.17, <0.0001) and in reducing urine microalbumin excretion rate (SMD 0.87, 95% CI 0.41-1.32, <0.0002). No serious adverse reactions were reported.

CONCLUSIONS

TCM formulas included in the LDWCFs are safe and effective in the treatment of DN proteinuria. These findings suggested that the TCM therapeutic principle of "kidney-tonifying" is a valuable addition to the treatment strategies for DN.

摘要

目的

糖尿病肾病（DN）是糖尿病的微血管并发症之一。蛋白尿是DN最重要的临床特征，也是DN疾病进展的独立危险因素；降低尿蛋白是DN治疗策略的主要目标。六味地黄丸类方（LDWCFs）是一组以“补肾”为目的的经典中药方剂，已广泛应用于DN的治疗。本研究旨在通过荟萃分析分析LDWCFs汤剂治疗DN蛋白尿的临床疗效，以全面了解“补肾”中医治法在DN治疗中的作用。

方法

检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Embase和考克兰图书馆；14项研究纳入荟萃分析。

结果

结果显示，LDWCFs治疗DN的总体疗效显著优于对照剂（OR=2.87，95%CI为1.98-4.15，P<0.00001）。这些方剂在降低24小时尿蛋白水平（MD=0.12，95%CI为0.06-0.17，P<0.0001）和降低尿微量白蛋白排泄率方面（SMD=0.87，95%CI为0.41-1.32，P<0.0002）显示出比对照剂更好的疗效。未报告严重不良反应。

结论

LDWCFs中的中药方剂治疗DN蛋白尿安全有效。这些发现表明，“补肾”中医治疗原则是DN治疗策略的一个有价值的补充。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a62/6178512/23e4ff9d5c89/ECAM2018-2427301.007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a62/6178512/aa60d84653bd/ECAM2018-2427301.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a62/6178512/618282af1ef8/ECAM2018-2427301.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a62/6178512/f115c9a01f99/ECAM2018-2427301.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a62/6178512/1305cbd870de/ECAM2018-2427301.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a62/6178512/11490a9c9e34/ECAM2018-2427301.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a62/6178512/c61f6dede482/ECAM2018-2427301.006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a62/6178512/23e4ff9d5c89/ECAM2018-2427301.007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a62/6178512/aa60d84653bd/ECAM2018-2427301.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a62/6178512/618282af1ef8/ECAM2018-2427301.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a62/6178512/f115c9a01f99/ECAM2018-2427301.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a62/6178512/1305cbd870de/ECAM2018-2427301.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a62/6178512/11490a9c9e34/ECAM2018-2427301.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a62/6178512/c61f6dede482/ECAM2018-2427301.006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a62/6178512/23e4ff9d5c89/ECAM2018-2427301.007.jpg

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