中药作为肾功能不全患者辅助治疗的疗效：一项系统评价和荟萃分析。
Efficacy of traditional Chinese medicine as an adjunctive treatment in patients with renal dysfunction: a systematic-review and meta-analysis.
作者信息
Wu Fenfang, Xu Chunhua, Si Xinlei, He Fei, Xu Kang, Zhang Yu, Lin Shan
机构信息
Department of Central Laboratory, Shenzhen Hospital, Beijing University of Chinese Medicine, Shenzhen, Guangdong, China.
Department of Nephrology, Longgang Central Hospital of Shenzhen, Shenzhen, Guangdong, China.
出版信息
Front Med (Lausanne). 2025 Jan 7;11:1477569. doi: 10.3389/fmed.2024.1477569. eCollection 2024.
OBJECTIVE
The effectiveness of using as an adjuvant therapy for patients with renal dysfunction (RD), especially acute kidney injury (AKI), is still a topic of debate. In response to the current conflicting data, the present meta-analysis was conducted to assess the clinical effectiveness of in the treatment of RD and to provide evidence for clinical practice.
METHODS
Several databases, including PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI) and Wanfang, were systematically searched updated to March 25, 2024. We used the combined ratio (OR) and diagnostic ratio (DOR) to assess the therapeutic effect of . In addition, risk of bias was assessed by Cochrane Risk of Bias Assessment Tool.
RESULTS
The present meta-analysis ultimately incorporated 15 studies comprising a total of 1,310 patients with RD. We pooled estimated the sensitivity, specificity as well as DOR from patient-based analyses with 0.89 (95% confidence interval [CI]: 0.84-0.93), 0.69 (95% CI: 0.59-0.77) and 18.0 (95% CI: 8.0-39.0), respectively. Moreover, we calculated the combined positive likelihood ratio (PLR) as well as negative likelihood ratio (NLR) to be 2.8 (95% CI: 2.1-3.9) and 0.16 (95% CI: 0.10-0.27), respectively. Additionally, area under the curve (AUC) of the summary receiver operating characteristic (SROC) was calculated as 0.88 (95% CI: 0.85-0.90) reflecting prognostic accuracy. Subsequently, subgroup analysis indicated that the clinical efficacy of in northern Chinese patients with RD was superior to that of southern. On the other hand, significantly reduced patients' blood creatinine levels, shortened the oliguria period, and increased urine osmolality, indicating it can improve the function of glomeruli and renal tubules.
CONCLUSION
Our results indicate that can be considered a dependable clinical treatment for individuals with RD. It may improve the function of glomeruli and tubules, promote the recovery of tubular function, and thus enhance the clinical therapeutic effects.
SYSTEMATIC REVIEW REGISTRATION
www.crd.york.ac.uk/PROSPERO/#recordDetails, identifier CRD42024559042.
目的
对于肾功能不全（RD）患者，尤其是急性肾损伤（AKI）患者，使用[具体治疗方法未给出]作为辅助治疗的有效性仍是一个有争议的话题。针对当前相互矛盾的数据，进行了本荟萃分析，以评估[具体治疗方法未给出]治疗RD的临床有效性，并为临床实践提供证据。
方法
系统检索了多个数据库，包括PubMed、EMBASE、Cochrane图书馆、中国知网（CNKI）和万方，检索截至2024年3月25日的最新文献。我们使用合并比值比（OR）和诊断比值比（DOR）来评估[具体治疗方法未给出]的治疗效果。此外，采用Cochrane偏倚风险评估工具评估偏倚风险。
结果
本荟萃分析最终纳入了15项研究，共1310例RD患者。我们通过基于患者的分析汇总估计敏感性、特异性以及DOR分别为0.89（95%置信区间[CI]：0.84 - 0.93）、0.69（95%CI：0.59 - 0.77）和18.0（95%CI：8.0 - 39.0）。此外，我们计算合并阳性似然比（PLR）和阴性似然比（NLR）分别为2.8（95%CI：2.1 - 3.9）和0.16（95%CI：0.10 - 0.27）。另外，汇总受试者工作特征曲线（SROC）的曲线下面积（AUC）计算为0.88（95%CI：0.85 - 0.90），反映预后准确性。随后的亚组分析表明，[具体治疗方法未给出]对中国北方RD患者的临床疗效优于南方患者。另一方面，[具体治疗方法未给出]显著降低了患者的血肌酐水平，缩短了少尿期，并增加了尿渗透压，表明它可以改善肾小球和肾小管的功能。
结论
我们的结果表明，[具体治疗方法未给出]可被认为是RD患者可靠的临床治疗方法。它可能改善肾小球和肾小管的功能，促进肾小管功能的恢复，从而提高临床治疗效果。
系统评价注册
www.crd.york.ac.uk/PROSPERO/#recordDetails，标识符CRD42024559042。
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