Zhang Ke-Xin, Li Xin, Chen Kai-Li, Dong Peng-Tao, Shi Lu-Yao, Zhang Lin-Qi
Department of Nephrology, First Affiliated Hospital of Henan University of Chinese Medicine Zhengzhou 450099, China.
the Fifth People's Hospital of Anyang Anyang 455000, China.
Zhongguo Zhong Yao Za Zhi. 2025 Jun;50(12):3413-3422. doi: 10.19540/j.cnki.cjcmm.20250226.502.
Through evidence mapping, this paper systematically summarized the research evidence on the use of traditional Chinese medicine(TCM) in treating renal anemia, displaying the distribution of evidence in this field. A systematic search was conducted across databases, including CNKI, Wanfang, VIP, SinoMed, Springner, PubMed, Engineering Village, and Web of Science, targeting studies published up to June 30, 2024. The research evidence was summarized and displayed through a combination of graphs, tables, and text. A total of 264 interventional studies, 37 observational studies, and 7 systematic reviews were included. The annual publication volumes related to TCM treatment in renal anemia showed an overall upward trend, with most studies involving sample sizes between 60 and 120 participants(224 articles, 74.42%). Intervention measures were categorized into 21 types, with oral TCM decoctions being the most common medicine(171 times, 56.81%). The use of self-made prescriptions was the most common TCM intervention method. The intervention duration was mainly between 8 weeks and 3 months(239 articles, 79.40%). The most frequently reported TCM syndrome was spleen and kidney Qi deficiency. The top 2 outcome indicators were the anemia indicators and renal injury/renal function markers. However, several issues were identified in these studies, such as insufficient attention to the sources, social/geographical information, and temporal continuity of research subjects in observational research. Randomized controlled trials mostly had a high risk of bias, mainly due to issues such as randomization bias, blinding bias, and failure to register research protocols. The methodology quality of systematic reviews was generally low, mainly due to inadequate inclusion of literature, failure to specify funding sources, and lack of pre-registrations. While the report quality of systematic review was acceptable, there were significant gaps in the reporting of protocols, registration, and funds. The results show that these issues affect the quality of research and the reliability of findings on TCM in treating renal anemia, underscoring the need to address them to conduct higher-quality research and provide more reliable medical evidence for TCM in treating renal anemia.
通过证据图谱，本文系统总结了中医药治疗肾性贫血的研究证据，展示了该领域证据的分布情况。对包括中国知网、万方、维普、中国生物医学文献数据库、施普林格、PubMed、工程索引和科学引文索引在内的数据库进行了系统检索，检索截至2024年6月30日发表的研究。通过图表和文本相结合的方式对研究证据进行了总结和展示。共纳入264项干预性研究、37项观察性研究和7项系统评价。肾性贫血中医药治疗相关的年发表量总体呈上升趋势，大多数研究的样本量在60至120例之间（224篇文章，占74.42%）。干预措施分为21种类型，口服中药汤剂是最常用的药物（171次，占56.81%）。使用自拟方剂是最常见的中医干预方法。干预持续时间主要在8周和3个月之间（239篇文章，占79.40%）。最常报道的中医证型是脾肾气虚。最常见的2个结局指标是贫血指标和肾损伤/肾功能标志物。然而，这些研究中发现了几个问题，如观察性研究中对研究对象的来源、社会/地理信息和时间连续性关注不足。随机对照试验大多存在较高的偏倚风险，主要原因是随机化偏倚、盲法偏倚和未注册研究方案等问题。系统评价的方法学质量普遍较低，主要原因是文献纳入不充分、未明确资助来源以及缺乏预注册。虽然系统评价的报告质量尚可，但在方案报告、注册和资金报告方面存在显著差距。结果表明，这些问题影响了中医药治疗肾性贫血的研究质量和结果的可靠性，强调需要解决这些问题以开展更高质量的研究，并为中医药治疗肾性贫血提供更可靠的医学证据。
