虫草制剂联合血管紧张素受体阻滞剂治疗糖尿病肾病的Meta分析

摘要

目的系统评价联合虫草制剂和血管紧张素受体阻滞剂(angiotension receptor blocker，ARB)治疗糖尿病肾病(diabetic nephropathy，DN)的疗效。方法检索Cochrane、PubMed、EMBASE、CBM、CNKI、万方和维普数据库(2012年11月)，纳入并Meta分析虫草制剂联合ARB治疗DN的随机对照试验(randomized controlled trials，RCT)。结果共纳入39项研究2653例患者。联合用药组可显著降低糖尿病肾病患者的24 h尿蛋白定量[P＜0.00001；MD=-100.31(-122.14，-78.48) mg/24 h；15项研究1752例患者]，尿微量白蛋白排泄率[P＜0.00001；MD=-22.18(-26.90，-17.47μg/min)；13项研究863例患者]和血肌酐[P＜0.0001；MD=-10.46(-15.50，-5.43μmol/L)；19项研究1999例患者]。结论加用虫草制剂可进一步降低DN患者的尿蛋白及改善肾功能。%Objective To systematically assess the effect of combined cordyceps sinensis and angiotension receptor blockers (ARB) on diabetic nephropathy (DN). Methods Randomized controlled trials (RCT) assessing the combined cordyceps sinensis and ARB therapy for DN were retrieved from Cochrane Library, PubMed, EMBASE, CBM, CNKI, WANFANG, and VIP (November 2012) and included in this meta-analysis. Results Thirty-nine RCT involving 2 653 patients were identified. The effect of combined cordyceps sinensis and ARB was better than that of ARB alone on the urinary protein excretion [P < 0.000 01, MD= -100.31 (-122.14,-78.48) mg/24 h, 15 trials involving 1 752 patients], urinary albumin excretion rate [P<0.000 01, MD=-22.18 (-26.90,-17.47)μg/min, 13 trials involving 863 patients], and serum creatinine [P<0.000 1;MD=-10.46 (-15.50,-5.43)μmol/L, 19 trials involving 1 999 patients]. Conclusion Combined cordyceps sinensis and ARB therapy can further reduce the urinary protein and improve the renal function in DN patients.