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金水宝联合 ACEI/ARB 治疗糖尿病肾病的临床疗效及安全性的 Meta 分析:随机对照试验的荟萃分析。

Clinical Efficacy and Safety of Jinshuibao Combined With ACEI/ARB in the Treatment of Diabetic Kidney Disease: A Meta-Analysis of Randomized Controlled Trials.

机构信息

Department of Nephrology, The Second Affiliated Hospital of Nanchang University, Nanchang, China.

Department of Nephrology, The Second Affiliated Hospital of Nanchang University, Nanchang, China.

出版信息

J Ren Nutr. 2020 Mar;30(2):92-100. doi: 10.1053/j.jrn.2019.03.083. Epub 2019 Jun 11.

DOI:10.1053/j.jrn.2019.03.083
PMID:31201013
Abstract

OBJECTIVE

The present study aims to compare the relative efficacy and safety of jinshuibao (JSB) combined with angiotensinconverting enzyme inhibitors/angiotensin receptor blockers (ACEIs/ARBs) in the treatment of diabetic kidney disease.

METHODS

We searched EMBASE, MEDLINE, PubMed, China National Knowledge Internet, the Chinese Biomedical Database, and Wanfang database for articles from the building of the database to September 2018.

RESULTS

Fifty-one randomized controlled trials with 3,955 participants were included. The meta-analysis indicated that compared with the controls, JSB combined with ACEI/ARB group could remarkably improve the overall response rate (odds ratio 4.91; 95% confidence interval [CI] 3.32-7.25) and reduce 24 h proteinuria (mean difference [MD] -0.16; 95% CI -0.19 to -0.13), urine albumin excretion ratio (MD -28.20; 95% CI -36.30 to -20.11), serum creatinine (MD -13.84; 95% CI -18.01 to -9.68), blood urea nitrogen (MD -1.00; 95% CI -1.36 to -0.63), systolic blood pressure (MD -4.57; 95% CI -6.78 to -2.37), diastolic blood pressure (MD -3.96; 95% CI -5.73 to -2.19), fasting blood glucose (MD -0.85; 95% CI -1.45 to -0.24), hemoglobin A1c (MD -0.52; 95% CI -0.83 to -0.21), serum total cholesterol (MD -0.53; 95% CI -0.86 to -0.20), and triglyceride (MD -0.53; 95% CI -0.55 to -0.51).

CONCLUSIONS

JSB combined with ACEI/ARB in the treatment of diabetic kidney disease is superior to the single application of ACEI/ARB.

摘要

目的

本研究旨在比较金水宝(JSB)联合血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂(ACEI/ARB)治疗糖尿病肾病的相对疗效和安全性。

方法

我们检索了 EMBASE、MEDLINE、PubMed、中国国家知识基础设施、中国生物医学文献数据库和万方数据库,检索时间从建库至 2018 年 9 月。

结果

纳入 51 项随机对照试验,共 3955 名参与者。Meta 分析表明,与对照组相比,JSB 联合 ACEI/ARB 组可显著提高总有效率(比值比 4.91;95%置信区间[CI] 3.32-7.25),并降低 24 小时尿蛋白(均数差[MD] -0.16;95%CI -0.19 至 -0.13)、尿白蛋白排泄率(MD -28.20;95%CI -36.30 至 -20.11)、血清肌酐(MD -13.84;95%CI -18.01 至 -9.68)、血尿素氮(MD -1.00;95%CI -1.36 至 -0.63)、收缩压(MD -4.57;95%CI -6.78 至 -2.37)、舒张压(MD -3.96;95%CI -5.73 至 -2.19)、空腹血糖(MD -0.85;95%CI -1.45 至 -0.24)、糖化血红蛋白(MD -0.52;95%CI -0.83 至 -0.21)、血清总胆固醇(MD -0.53;95%CI -0.86 至 -0.20)和三酰甘油(MD -0.53;95%CI -0.55 至 -0.51)。

结论

JSB 联合 ACEI/ARB 治疗糖尿病肾病优于 ACEI/ARB 单药治疗。

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