灯盏花素注射液联合降压药治疗高血压肾病：一项系统评价与Meta分析

Combined Therapy of Hypertensive Nephropathy with Breviscapine Injection and Antihypertensive Drugs: A Systematic Review and a Meta-Analysis.

作者信息

Wu Lihua, Liu Ming, Fang Zhuyuan

机构信息

Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210029, China.

Institute of Hypertension, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210029, China.

出版信息

Evid Based Complement Alternat Med. 2018 Dec 20;2018:2958717. doi: 10.1155/2018/2958717. eCollection 2018.

OBJECTIVE

To evaluate the beneficial and adverse effects of breviscapine injection in combination with antihypertensive drugs for treating hypertensive nephropathy in clinical practice.

METHODS

We searched PubMed, the Cochrane Library, Embase, CNKI, Sino Med, VIP, and Wanfang Data for relevant literature. The timeframe of retrieval was set from the founding date of each database to September 28, 2018.

RESULTS

Fourteen papers were included in this study. The quality of all the studies included was determined to be low. All studies were conducted with Chinese populations. Meta-analysis showed that, compared with single-use antihypertensive drugs, using breviscapine injection in combination with antihypertensive drugs to treat hypertensive nephropathy can reduce serum creatinine (Scr) [WMD = -35.16, 95% CI(-50.01, -20.31), ≤ 0.001], blood urea nitrogen (BUN) [WMD = -2.00, 95% CI(-3.07, -0.94), ≤ 0.001], 24-hour urinary total protein (24 h UTP) [WMD = -0.04, 95% CI(-0.05, -0.02), ≤ 0.001], and the beta-2-microglobulin (B2M) [WMD = -0.09, 95% CI(-0.11, -0.07), ≤ 0.001], improve creatinine clearance rate (Ccr) [WMD = 7.84, 95% CI(5.20, 10.49), ≤ 0.001], and increase the clinical efficacy [RR = 1.27, 95% CI(1.05, 1.53), = 0.014], but does not lower systolic blood pressure (SBP) [WMD = -1.02, 95% CI(-2.88, 0.84), = 0.281]. There was no significant difference in adverse events between experimental groups and control groups.

CONCLUSION

Breviscapine injection in combination with antihypertensive drugs can improve clinical efficacy and Ccr and reduce Scr, BUN, 24 h UTP, and B2M in patients with hypertensive nephropathy. The present meta-analysis indicated that breviscapine injection can serve as a renal protective effect to patients with hypertensive nephropathy. However, the evidence of methodological quality and sample sizes is weak, and thus, further standardized research is required.

目的

评价灯盏花素注射液联合降压药物治疗高血压肾病的临床疗效及不良反应。

方法

检索PubMed、Cochrane图书馆、Embase、中国知网、中国生物医学文献数据库、维普数据库和万方数据等相关文献。检索时间范围设定为各数据库建库至2018年9月28日。

结果

本研究共纳入14篇文献。纳入的所有研究质量均较低。所有研究均以中国人群为研究对象。Meta分析结果显示，与单纯使用降压药物相比，灯盏花素注射液联合降压药物治疗高血压肾病可降低血清肌酐（Scr）[加权均数差（WMD）=-35.16，95%可信区间（CI）为（-50.01，-20.31），P≤0.001]、血尿素氮（BUN）[WMD=-2.00，95%CI为（-3.07，-0.94），P≤0.001]、24小时尿总蛋白（24 h UTP）[WMD=-0.04，95%CI为（-0.05，-0.02），P≤0.001]及β2微球蛋白（B2M）[WMD=-0.09，95%CI为（-0.11，-0.07），P≤0.001]，提高肌酐清除率（Ccr）[WMD=7.84，95%CI为（5.20，10.49），P≤0.001]，并提高临床疗效[相对危险度（RR）=1.27，95%CI为（1.05，1.53），P=0.014]，但不能降低收缩压（SBP）[WMD=-1.02，95%CI为（-2.88，0.84），P=0.281]。试验组与对照组在不良事件方面差异无统计学意义。