针药治疗糖尿病肾病Meta分析

Acupuncture and Herbal Therapy for Diabetic Nephropathy: A Meta-Analysis

摘要: 目的：通过Meta分析评价针药治疗糖尿病肾病(DN)的临床疗效以及各项相关指标的变化。方法：采用PubMed、CBM、CNKI、万方、VIP数据库进行检索，筛选自建库至2022年10月15日针药治疗DN的随机对照实验，运用RevMan5.4软件对符合纳入标准的文献进行meta分析。结果：最终纳入12项符合标准的随机对照实验，共计916例DN患者，其中试验组458例，对照组458例。Meta分析结果显示针药联合常规治疗组vs单纯常规治疗组中，针药组治疗糖尿病肾病总体疗效好，有效率RR = 1.25 [1.18, 1.34]，Z = 6.86，P < 0.00001；血肌酐(Scr) WMD = −12.28 [−17.51, −7.05]，Z = 4.60，P < 0.00001；尿素氮(BUN) WMD = −1.36 [−1.91, −0.82]，Z = 4.88，P < 0.00001；24 h尿蛋白定量WMD = −278.40 [−354.12, −202.68]，Z = 7.21，P < 0.00001；空腹血糖WMD = −0.54 [−0.89, −0.30]，Z = 3.04，P = 0.002；糖化血红蛋白(HbA1c) WMD = −0.50 [−1.02, −0.02]，Z = 1.87，P = 0.06。结论：针药治疗DN有助于提高临床有效率，降低24小时尿蛋白定量，延缓肾功能恶化，调节血糖水平。

Abstract: Objective: To evaluate the clinical efficacy of acupuncture and herbal therapy of diabetic nephrop-athy (DN) and the changes of various related indicators through meta-analysis. Methods: PubMed, CBM, CNKI, Wanfang, and VIP databases were used to search, and the randomized controlled trials of acupuncture and medicine in the treatment of DN from the establishment of the database to Oc-tober 15, 2022 were screened, and RevMan5.4 software was used to perform meta-analysis of the literatures that met the inclusion criteria. Results: 12 randomized controlled trials that met the criteria were finally included, with a total of 916 DN patients, including 458 in the experimental group and 458 in the control group. Meta-analysis results showed that in the acupuncture- medi-cine combined with conventional treatment group vs the conventional treatment group alone, the acupuncture-medicine group had better overall curative effect in the treatment of diabetic nephropathy. The results of meta-analysis showed that the acupuncture and Chinese medicine combined with conventional treatment group versus conventional treatment group alone had a good overall effect on diabetic nephropathy, with an effective rate of RR = 1.25 [1.18, 1.34], Z = 6.86, P < 0.00001; Serum creatinine (Scr) WMD = −12.28 [−17.51, −7.05], Z = 4.60, P < 0.00001; Urea ni-trogen (BUN) WMD = −1.36 [−1.91, −0.82], Z = 4.88, P < 0.00001; 24 h urine protein quantification WMD = −278.40 [−354.12, −202.68], Z = 7.21, P < 0.00001; Fasting blood glucose WMD = −0.54 [−0.89, −0.30], Z = 3.04, P = 0.002; HbA1c WMD = −0.50 [−1.02, −0.02], Z = 1.87, P = 0.06. Conclu-sion: Acupuncture and medicine in the treatment of DN can help to improve the clinical efficiency, reduce the 24-hour urine proteinquantitative, delay the deterioration of renal function, and regu-late the blood sugar level.