银杏叶提取物与双嘧达莫注射液联合降压药物治疗高血压肾病的系统评价及荟萃分析。
Combined therapy of hypertensive nephropathy with ginkgo leaf extract and dipyridamole injection and antihypertensive drugs: A systematic review and meta-analysis.
机构信息
Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
出版信息
Medicine (Baltimore). 2021 May 14;100(19):e25852. doi: 10.1097/MD.0000000000025852.
BACKGROUND
In recent years, the incidence rate of hypertensive nephropathy has been increasing quickly, which has been a major threat to people's health. Renin-angiotensin-aldosterone system blockers have certain curative effects. However, there are some patients having serious adverse reactions, and the benefit population is limited, so the treatment of hypertensive renal damage is necessary to have beneficial supplement. More and more clinical studies have shown that ginkgo leaf extract and dipyridamole injection (GDI) combined with antihypertensive drugs has achieved good results in the treatment of hypertensive renal damage. It is supposed to be a supplementary treatment in hypertensive nephropathy.
OBJECTIVES
To systematically assess the efficacy and safety of GDI combined with antihypertensive drugs on hypertensive renal injury.
METHODS
Seven databases including PubMed, Cochrane Library, Embase, Wanfang database, China biomedical literature service system (Sino Med), VIP Chinese Sci-tech journal database (VIP), and China national knowledge internet (CNKI) were retrieved to collect randomized controlled trials (RCTs) in the experimental group containing combined therapy of hypertensive nephropathy with GDI and antihypertensive drugs. The retrieval time was from the establishment of database to July 8, 2020. Two researchers independently selected literature, extracted data, and evaluated the risk of bias in the study. The methodological quality was evaluated with Cochrane handbook and meta-analysis was performed with Stata 14.0 software.
RESULTS
Eight studies were included in this study which involved 556 patients. The meta-analyses indicated that, compared with using antihypertensive drugs alone, combined treatment of GDI with antihypertensive drugs can decrease 24-hour urinary total protein (weighted mean difference [WMD] -0.61, 95% confidence interval [CI]: -0.82, -0.39; k = 6, P ≤ .001), blood urea nitrogen (WMD -1.27, 95% CI: -2.45, -0.10; k = 6, P = .033, serum creatinine (WMD -29.50, 95% CI: -56.44, -2.56; number of estimates [k] = 6, P = .032).
CONCLUSIONS
Our meta-analyses showed that GDI combined with antihypertensive drugs can improve the renal function of hypertensive patients with renal injury.
背景
近年来，高血压肾病的发病率迅速上升，已成为严重威胁人们健康的主要因素之一。肾素-血管紧张素-醛固酮系统阻滞剂有一定的疗效。但是，有一些患者出现严重的不良反应，而且受益人群有限，因此高血压肾损害的治疗有必要进行有益的补充。越来越多的临床研究表明，银杏叶提取物与双嘧达莫注射液（GDI）联合降压药物在治疗高血压肾损害方面取得了良好的效果。它被认为是高血压肾病的一种补充治疗方法。
目的
系统评价 GDI 联合降压药物治疗高血压肾损伤的疗效和安全性。
方法
检索 PubMed、Cochrane 图书馆、Embase、万方数据库、中国生物医学文献服务系统（Sino Med）、维普中文科技期刊数据库（VIP）和中国知网（CNKI）等 7 个数据库，收集实验组采用银杏叶提取物与降压药物联合治疗高血压肾病的随机对照试验（RCT）。检索时间从数据库建立到 2020 年 7 月 8 日。两名研究人员独立筛选文献、提取数据，并对研究的偏倚风险进行评估。采用 Cochrane 手册评价方法学质量，采用 Stata 14.0 软件进行荟萃分析。
结果
本研究纳入了 8 项研究，共 556 名患者。荟萃分析结果表明，与单独使用降压药物相比，银杏叶提取物与降压药物联合治疗可降低 24 小时尿总蛋白（加权均数差[WMD]-0.61，95%置信区间[CI]：-0.82，-0.39；k=6，P≤0.001）、血尿素氮（WMD-1.27，95%CI：-2.45，-0.10；k=6，P=0.033）和血清肌酐（WMD-29.50，95%CI：-56.44，-2.56；k=6，P=0.032）。
结论
我们的荟萃分析结果表明，银杏叶提取物与降压药物联合使用可改善高血压肾病患者的肾功能。
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