Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Department of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Ann Palliat Med. 2021 Jun;10(6):6736-6752. doi: 10.21037/apm-21-1220. Epub 2021 Jun 16.
This research sought to systematically evaluate the clinical effects of traditional Chinese medicine (TCM) intervention in the treatment of diabetic nephropathy (DN) and analyze changes in thyroid function in patients with DN.
The PubMed, Embase, Medline, Ovid, Springer, and self-built databases were searched to screen literature on TCM intervention and the treatment of DN published from the establishment of the databases to January 1, 2021. The Cochrane Handbook for Systematic Reviews of Intervention 5.0.2 was then employed to assess the risk of bias in literature, and Review Manager 5.3 was utilized for the meta-analysis.
A total of 20 randomized controlled trials (RCTs) were included in the study, involving 3,566 subjects, and meta-analysis results showed that the clinical treatment efficiency of the experimental group was dramatically higher than the control group [MD =6.22, 95% confidence interval (CI): 3.77-10.25, Z=7.17, P<0.00001]. Moreover, the serum creatinine (Scr), blood urea nitrogen (BUN), urine protein excretion rate (UAER), 24 h postoperative urine protein quantification, and tumor necrosis factor-alpha (TNF-α) of patients after TCM intervention were all remarkably inferior to those of the control group as seen in the following results: Scr, MD =-8.69, 95% CI: -9.92 to -7.47, Z=13.94, P<0.00001; BUN, MD =-1.74, 95% CI: - 2.48 to -1.00, Z=4.6, P<0.00001; UAER, MD =-26.16, 95% CI: -46.89 to -5.44, Z=2.47, P=0.01; 24 h postoperative urine protein quantification, MD =-0.54, 95% CI: -0.68 to -0.4, Z=7.4, P<0.00001; TNF-α, MD =-5.3, 95% CI: -9.15 to -1.46, Z=2.7, P=0.007; and high sensitivity C-reactive protein (hs-CRP), MD =-1.34, 95% CI: -1.9 to -0.78, Z=4.66, P<0.00001.
TCM intervention in DN is effective in treating the clinical symptoms of patients with this disease and has ideal therapeutic effects.
本研究旨在系统评估中医药干预治疗糖尿病肾病（DN）的临床效果，并分析 DN 患者甲状腺功能的变化。
检索PubMed、Embase、Medline、Ovid、Springer 和自建数据库，筛选建库至 2021 年 1 月 1 日发表的中医药干预治疗 DN 的文献。采用 Cochrane 系统评价手册 5.0.2 评估文献偏倚风险，采用 Review Manager 5.3 进行 meta 分析。
共纳入 20 项随机对照试验（RCT），涉及 3566 例患者，meta 分析结果显示，实验组的临床治疗有效率明显高于对照组[MD=6.22，95%置信区间（CI）：3.77-10.25，Z=7.17，P<0.00001]。此外，中医药干预后患者的血清肌酐（Scr）、血尿素氮（BUN）、尿蛋白排泄率（UAER）、24 h 术后尿蛋白定量、肿瘤坏死因子-α（TNF-α）均明显低于对照组，结果如下：Scr，MD=-8.69，95%CI：-9.92 至-7.47，Z=13.94，P<0.00001；BUN，MD=-1.74，95%CI：-2.48 至-1.00，Z=4.6，P<0.00001；UAER，MD=-26.16，95%CI：-46.89 至-5.44，Z=2.47，P=0.01；24 h 术后尿蛋白定量，MD=-0.54，95%CI：-0.68 至-0.4，Z=7.4，P<0.00001；TNF-α，MD=-5.3，95%CI：-9.15 至-1.46，Z=2.7，P=0.007；超敏 C 反应蛋白（hs-CRP），MD=-1.34，95%CI：-1.9 至-0.78，Z=4.66，P<0.00001。
中医药干预治疗 DN 能有效改善患者的临床症状，具有理想的治疗效果。
