1.河南省中医院(河南中医药大学第二附属医院)肾病科(河南 郑州 450002)
2.河南中医药大学第二临床医学院(河南 郑州 450008)
庞欣欣,男,博士,副主任医师,硕士研究生导师,主要从事中医药治疗慢性肾脏病的临床研究工作
韩佳瑞,教授,硕士研究生导师; E-mail:HanJR2018@126.com
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庞欣欣,石秀杰,张雅歌,等.银杏叶提取物治疗糖尿病肾病疗效和安全性的Meta分析[J].上海中医药杂志,2023,57(1):16-24.
PANG Xinxin,SHI Xiujie,ZHANG Yage,et al.Meta-analysis on efficacy and safety of Ginkgo Folium extract in treating diabetic kidney disease[J].Shanghai Journal of Traditional Chinese Medicine,2023,57(1):16-24.
庞欣欣,石秀杰,张雅歌,等.银杏叶提取物治疗糖尿病肾病疗效和安全性的Meta分析[J].上海中医药杂志,2023,57(1):16-24. DOI: 10.16305/j.1007-1334.2023.2007098.
PANG Xinxin,SHI Xiujie,ZHANG Yage,et al.Meta-analysis on efficacy and safety of Ginkgo Folium extract in treating diabetic kidney disease[J].Shanghai Journal of Traditional Chinese Medicine,2023,57(1):16-24. DOI: 10.16305/j.1007-1334.2023.2007098.
目的,2,评价银杏叶提取物治疗糖尿病肾病(DKD)的疗效及安全性,为其临床应用提供循证医学证据。,方法,2,计算机检索PubMed数据库、Cochrane图书馆、EMbase数据库、Wiley数据库、Ovid数据库、中国知网(CNKI)、维普网(VIP)、万方(Wan Fang)数据库、中国生物医学文献数据库(CBM)建库至今的相关文献,采用Cochrane协作网“偏倚风险评估工具”进行文献质量评价。提取所纳入研究疗效指标,并采用RevMan 5.3软件进行分析。,结果,2,①共纳入20项随机对照研究,共1 375例DKD患者。②Meta分析结果显示,与单用西医治疗相比,银杏叶提取物联合西医治疗可以提高DKD患者的总有效率[,OR,=5.52, 95%,CI,(3.46,8.81),,P,<,0.000 01]。③尿蛋白排泄率(UAER)、总胆固醇(TC)、三酰甘油(TG)、血肌酐(SCr)、尿素氮(BUN)均存在较大异质性,故将银杏叶提取物根据用药方式不同分为静滴组和口服组,进行亚组分析。结果显示,银杏叶提取物静滴组与口服组DKD患者UAER、TC、TG均显著降低,差异均有统计学意义(,P,<,0.000 1);银杏叶提取物静滴组在改善DKD患者SCr方面差异无统计学意义(,P,>,0.05),银杏叶提取物口服组在改善DKD患者SCr方面差异有统计学意义(,P,<,0.05)。银杏叶提取物静滴组和银杏叶提取物口服组在改善DKD患者BUN方面差异无统计学意义(,P,>,0.05)。④纳入研究均未发现明显不良反应。,结论,2,与单纯西医治疗相比,银杏叶提取物联合西医治疗能提高DKD患者临床有效率、降低蛋白尿、改善脂代谢,且安全性良好。
Objective,2,To evaluate the efficacy and safety of Ginkgo Folium extract in the treatment of diabetic kidney disease(DKD), and provide evidence for the clinical application.,Methods,2,The literatures of PubMed Database, Cochrane Library, Embase Database, Wiley Database, Ovid Database, CNKI, VIP, Wan Fang Database and CBM were searched by computer, and the quality of literatures was evaluated by the Cochrane collaboration’s tool for assessing risk of bias. The included efficacy indicators were extracted and analyzed with RevMan 5.3 software.,Results,2,①A total of 1 375 patients in twenty randomized controlled trails diagnosed with DKD were included. ②Meta-analysis results showed as follows: compared with western medicine treatment alone, Ginkgo Folium extract combined with western medicine treatment in DKD patients could improve total efficacy rate[,OR,=5.52, 95%,CI,(3.46,8.81), ,P,<,0.000 01]. ③UAER, TC, TG, SCr, and BUN all showed great heterogeneity, so Ginkgo Folium extract was divided into intravenous drip group and oral group according to different medication methods, and subgroup analysis was conducted. The results showed that Ginkgo Folium extract could significantly reduce UAER, TC and TG in patients with DKD both in the intravenous drip group and the oral group(,P,<,0.000 1). In terms of the efficacy of Ginkgo Folium extract on SCr, there had no statistically significant difference in intravenous drip(,P,>,0.05), while there had statistically significant difference in the oral group(,P,<,0.05). In terms of the efficacy of Ginkgo Folium extract on BUN, there had no statistically significant difference both in intravenous drip group and oral group(,P,>,0.05). ④No significant adverse reactions were found in the included studies.,Conclusion,2,Compared with western medicine alone,Ginkgo Folium extract combined with western medicine could improve the clinical efficacy, reduce proteinuria, improve lipid metabolism in DKD patients, and with good safety.
糖尿病肾病银杏叶提取物临床疗效中西医结合Meta分析
diabetic kidney diseaseGinkgo Folium extractclinical efficacycombination of traditional Chinese medicine and western medicineMeta-analysis
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