| 引用本文:郑威1，范思为2，吴光辉1，徐艳秋1.经方治疗糖尿病肾病有效性和安全性的网状Meta分析[J].世界中医药,2024,(19):. |
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| 经方治疗糖尿病肾病有效性和安全性的网状Meta分析 |
| Efficacy and Safety of Classical Formulas from Traditional Chinese Medicine for Diabetic Nephropathy：A Network Meta-analysis |
| 投稿时间：2023-10-25 |
| DOI：10.3969/j.issn.1673-7202.2024.19.010 |
| 中文关键词: 经方 糖尿病肾病 网状Meta分析 抵当汤 真武汤 肾气丸 黄芪桂枝五物汤 苓桂术甘汤 |
| English Keywords:Classical formulas Diabetic nephropathy Network Meta-analysis Didang Decoction Zhenwu Decoction Shenqi Pills Huangqi Guizhi Wuwu Decoction Linggui Zhugan Decoction |
| 基金项目:国家自然科学基金项目（82274391）；上海市科技委员会项目（21Y11922900） |
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| 中文摘要: |
| 目的：基于网状Meta分析，评估不同经方治疗糖尿病肾病的有效性和安全性。方法：计算机检索国家知识基础设施数据库、中国学术期刊数据库、中文科技期刊数据库、中国生物医学文献数据库、PubMed、Cochrane Library、EMbase、Web of Science等数据库。检索自建库起至2023年8月31日期间有关经方治疗糖尿病肾病患者的随机对照试验。所有研究人员均独立筛选文献、提取资料，采用Cochrane偏倚风险评价工具评估纳入文献的质量，对符合质量标准的文献采用Stata 13.0软件进行数据分析。结果：最终纳入116项随机对照试验，涉及13种经方，总样本量10 089例，其中观察组5 111例，对照组4 978例。网状Meta分析结果显示，1）抵当汤+西医常规治疗在改善临床疗效方面可能是最有效的干预措施；2）真武汤+西医常规治疗在改善尿白蛋白排泄率（UAER）和糖化血红蛋白（HbA1c）方面是最有效的；3）肾气丸+西医常规治疗在改善24 h尿蛋白定量（24 h UTP）方面是最有效的；4）黄芪桂枝五物汤+西医常规治疗在降低血糖方面是最有效的；5）真武汤+苓桂术甘汤+西医常规治疗在改善血肌酐（Scr）和血尿素氮（BUN）方面是最有效的。结论：经方联合西医常规治疗的方案能够降低UAER、24 h UTP，同时对于降低Scr、BUN、空腹血糖（FBG）、HbA1c并提高临床总有效率，联合用药明显优于单纯西医常规治疗。 |
| English Summary: |
| To evaluate the efficacy and safety of different traditional Chinese medicine(TCM) classical formulas in treating diabetic nephropathy based on network Meta-analysis.Methods:A computer-based search was conducted in databases including Chinese National Knowledge Infrastructure(CNKI)，China Academic Journal Database(CSPD)，Chinese Sci-tech Journal Database(CCD)，China Biomedical Literature Database，PubMed，Cochrane Library，EMbase，and Web of Science，covering studies from database inception to August 31，2023.Randomized controlled trials(RCTs) on TCM classical formulas for treating diabetic nephropathy patients were included.All researchers independently screened the literature and extracted data，using the Cochrane bias risk assessment tool to evaluate the quality of the included studies.Data analysis was performed using Stata 13.0 software for studies meeting quality standards.Results:A total of 116 RCTs were included，involving 13 TCM classical formulas and a total sample size of 10 089 participants，with 5 111 in the observation group and 4 978 in the control group.Network Meta-analysis showed that：1) Didang Decoction+conventional Western medicine was likely the most effective intervention for improving clinical efficacy; 2) Zhenwu Decoction+conventional Western medicine was most effective in improving urinary albumin excretion rate(UAER) and HbA1c; 3) Shenqi Pills+conventional Western medicine was most effective in improving 24-hour urine protein quantification(24 h UTP); 4) Huangqi Guizhi Wuwu Decoction+conventional Western medicine was most effective in lowering blood sugar; 5) Zhenwu Decoction+Linggui Zhugan Decoction+conventional Western medicine was most effective in improving serum creatinine(Scr) and blood urea nitrogen(BUN).Conclusion:TCM classical formulas combined with conventional Western medicine can significantly lower UAER and 24 h UTP，and also reduce Scr，BUN，fasting blood glucose(FBG)，HbA1c，and improve overall clinical efficacy，with combined therapy being superior to conventional Western medicine alone. |
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