Liu Meixi, Cui Chengji, Chang Tianying, Zhou Qingshan, Cui Yingzi, Zhang Shoulin, Liao Xing
College of Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China.
Nephropathy Department, The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, China.
Front Pharmacol. 2024 Jul 19;15:1360997. doi: 10.3389/fphar.2024.1360997. eCollection 2024.
(), a genus of ascomycete fungi, has been widedly used in China as a dietary supplement or natural remedy and intensively studied in various disease models with its immunomodulatory potentials. It is a rich source of various bioactive compounds and used for treating end-stage renal disease. This systematic review with clinical evidence aimed to highlight the efficacy and safety of as an adjuvant treatment for patients undergoing dialysis.
A systematic search through nine electronic databases up to 31 April 2024, was conducted for related studies. The Cochrane risk-of-bias tool was used to evaluate the quality of studies. The Grading of Recommendations Assessment, Development, and Evaluation system was used to assess the certainty of evidence. Two researchers independently searched the literature and evaluated the risk of bias.
After the screening, 35 randomized controlled trials (RCTs) involving 2,914 patients were eventually included. The meta-analysis showed that using effectively reduced the following outcomes in patients undergoing dialysis: C-reactive protein (15RCTs, MD = -2.22, 95% CI -3.24 to -1.20; very low certainty evidence); creatinine (22RCTs, MD =1.33, 95% CI -1.79 to -0.87; very low certainty evidence); blood urea nitrogen (21RCTs, MD = -1.57, 95% CI -2.07 to -1.07; low certainty evidence);. It could also effectively improve the following outcomes in patients undergoing dialysis: albumin (20RCTs, MD = -0.81, 95% CI -1.21 to -0.41; low certainty evidence); hemoglobin (19RCTs, MD = -1.00, 95% CI -1.43 to -0.57; low certainty evidence). The rate of adverse drug reactions was higher in the control group than in the experimental group (4RCTs, MD = 1.81, 95% CI 0.88-3.74).
The current evidence indicates that patients with dialysis receiving in the adjuvant treatment may improve nutritional and micro-inflammatory status and renal function for both hemodialysis and peritoneal dialysis patients. However, some limitation affected the generalizability of our findings. High-quality studies evaluating mortality outcomes of patients with different dialytic modalities in CKD are warranted in future.
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022324508, registration number CRD42022324508.
（），一种子囊菌属真菌，在中国已被广泛用作膳食补充剂或天然药物，并因其免疫调节潜力在各种疾病模型中得到深入研究。它是多种生物活性化合物的丰富来源，用于治疗终末期肾病。本项具有临床证据的系统评价旨在强调（）作为透析患者辅助治疗的有效性和安全性。
对截至2024年4月31日的九个电子数据库进行系统检索，以查找相关研究。使用Cochrane偏倚风险工具评估研究质量。使用推荐分级评估、制定和评价系统评估证据的确定性。两名研究人员独立检索文献并评估偏倚风险。
筛选后，最终纳入了35项涉及2914名患者的随机对照试验（RCT）。荟萃分析表明，使用（）可有效降低透析患者的以下指标：C反应蛋白（15项RCT，MD = -2.22，95%CI -3.24至-1.20；极低确定性证据）；肌酐（22项RCT，MD =1.33，95%CI -1.79至-0.87；极低确定性证据）；血尿素氮（21项RCT，MD = -1.57，95%CI -2.07至-1.07；低确定性证据）。它还可有效改善透析患者的以下指标：白蛋白（20项RCT，MD = -0.81，95%CI -1.21至-0.41；低确定性证据）；血红蛋白（19项RCT，MD = -1.00，95%CI -1.43至-0.57；低确定性证据）。对照组的药物不良反应发生率高于试验组（4项RCT，MD = 1.81，95%CI 0.88 - 3.74）。
当前证据表明，接受（）辅助治疗的透析患者，无论血液透析还是腹膜透析患者，其营养和微炎症状态以及肾功能可能会得到改善。然而，一些局限性影响了我们研究结果的普遍性。未来需要高质量的研究来评估CKD中不同透析方式患者的死亡率结局。
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022324508，注册号CRD42022324508 。
需注意，原文括号处有内容缺失未给出具体信息，译文按原样保留了括号。
