中医药治疗慢性肾脏病临床效果的meta 分析

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摘要目的采用系统评价与meta 分析探讨中医药治疗慢性肾脏病的临床效果。方法计算机检索国内外数据库，并按照纳入和排除标准筛选出符合条件的文献，经文献数据提取、质量评价后采用RevMan5.3 软件进行meta 分析。结果纳入17 篇随机对照试验（RCT），共1 151 例患者，大多数纳入试验质量偏低。meta 分析结果显示，试验组的总有效率（I2=33%，RR=1.31，95%CI：1.22～1.40）、肾小球滤过率（I2=50%，WMD=4.04，95%CI：2.04～6.05）高于对照组，血肌酐（I2=29%，WMD=-15.42，95%CI：-18.32～-12.51）、尿素氮（I2=77%，WMD=-1.27，95%CI：-1.81～-0.73）、中医证候积分（I2=89%，WMD=-6.97，95%CI：-9.47～-4.47）、24 h 尿蛋白定量（I2=0%，WMD=-0.12，95%CI：-0.21～-0.03）低于对照组，差异有统计学意义（P＜0.05）。结论中医药联合西医常规治疗慢性肾脏病，效果更佳，可改善中医症状和肾功能。

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关键词 ：中医药, 慢性肾脏病, 临床疗效, 随机对照试验, Meta 分析

Abstract：Objective To investigate the clinical efficacy of traditional Chinese medicine in the treatment of chronic kidney disease by systematic review and meta-analysis.Methods Domestic and foreign databases were searched by computer,and eligible literatures were selected according to inclusion and exclusion criteria.Meta-analysis was performed using RevMan5.3 software after literature data extraction and quality evaluation.Results Seventeen randomized controlled trials(RCT) were included,with a total of 1 151 patients,most of which were of low quality.The total effective rate (I2=33%,RR=1.31,95%CI: 1.22-1.40) and glomerular filtration rate (I2=50%, WMD=4.04,95%CI: 2.04-6.05) in experimental groups were higher than those in control group,serum creatinine (I2=29%, WMD=-15.42,95%CI: -18.32--12.51),urea nitrogen (I2=77%, WMD=-1.27,95%CI: -1.81--0.73),traditional Chinese medicine syndrome score (I2=89%,WMD=-6.97,95%CI: -9.47--4.47),24 h urinary protein quantity (I2=0%, WMD=-0.12,95%CI: -0.21--0.03) were lower than those of the control group,the differences were statistically significant (P ＜0.05).Conclusion Traditional Chinese medicine combined with western medicine conventional treatment of chronic kidney disease,the effect is better,can improve the symptoms of traditional Chinese medicine and kidney function.

Key words： Traditional Chinese medicine Chronic kidney disease Clinical effect Randomized controlled trials Meta-analysis

基金资助:江西省中医药管理局科技计划项目（2021B519）。

作者简介: 雷文明（1990-），男，硕士；研究方向：中医肺病的临床和循证医学。

引用本文:

周婷；雷文明；冯伟；刘萍；贺东红. 中医药治疗慢性肾脏病临床效果的meta 分析[J]. 中国当代医药, 2024, 31(11): 4-08.
ZHOU Ting LEI Wenming FENG Wei LIU Ping HE Donghong. Meta-analysis of the clinical effect of traditional Chinese medicine on chronic kidney disease. 中国当代医药, 2024, 31(11): 4-08.

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