浏览全部资源
扫码关注微信
1.湖南中医药大学第一附属医院内分泌内科,长沙 410007
2.湖南中医药大学研究生院,长沙 410208
Published:15 December 2023,
Received:01 March 2023,
Revised:16 August 2023,
扫 描 看 全 文
王屹菲,周敏,喻嵘.雷公藤多苷治疗糖尿病肾病的系统评价再评价 Δ[J].中国药房,2023,34(23):2915-2921.
WANG Yifei,ZHOU Min,YU Rong.Reevaluation of systematic evaluation of Tripterygium glycosides in the treatment of diabetic kidney disease[J].ZHONGGUO YAOFANG,2023,34(23):2915-2921.
王屹菲,周敏,喻嵘.雷公藤多苷治疗糖尿病肾病的系统评价再评价 Δ[J].中国药房,2023,34(23):2915-2921. DOI: 10.6039/j.issn.1001-0408.2023.23.18.
WANG Yifei,ZHOU Min,YU Rong.Reevaluation of systematic evaluation of Tripterygium glycosides in the treatment of diabetic kidney disease[J].ZHONGGUO YAOFANG,2023,34(23):2915-2921. DOI: 10.6039/j.issn.1001-0408.2023.23.18.
目的
2
针对雷公藤多苷(TG)治疗糖尿病肾病(DKD)的系统评价/Meta分析进行系统评价再评价(伞形综述),以期为TG治疗DKD提供更高质量的循证依据。
方法
2
检索中国知网、万方、维普、中国生物医学文献数据库和PubMed、Cochrane Library、Embase数据库中TG治疗DKD的系统评价/Meta分析,通过PRISMA 2020声明、AMSTAR 2量表、GRADE工具分别进行报告质量、方法学质量及证据质量评价,同时对纳入系统评价/Meta分析的定量结果进行综合分析。
结果
2
共纳入18篇系统评价/Meta分析,PRISMA 2020声明评价结果显示,3篇文献报告较完整,13篇报告存在部分信息缺陷,2篇报告存在严重信息缺陷;AMSTAR 2量表评价结果显示,4篇文献方法学质量等级为低级,14篇文献方法学质量等级为极低级;GRADE工具评价结果显示,共106个结局指标,中级证据34个(占比为32.1%)、低级证据51个(占比为48.1%),极低级证据21个(占比为19.8%),无高级证据;各结局指标定量结果综合分析显示,TG对DKD总有效率、24 h尿蛋白定量、血清白蛋白均有确切改善作用,各研究不良反应结果不统一。
结论
2
TG治疗DKD疗效较为确切,安全性仍需关注,未来有待更大样本量的研究进行验证。
OBJECTIVE
2
To systematically reevaluate (umbrella review) the systematic review/meta-analysis of
Tripterygium
glycosides (TG) in the treatment of diabetic kidney disease (DKD), in order to provide a higher quality evidence-based reference for TG in the treatment of DKD.
METHODS
2
The systematic reviews/meta-analysis of TG in the treatment of DKD were searched from CNKI, Wanfang, VIP, CBM, PubMed, Cochrane Library and Embase. The PRISMA 2020 statement, the AMSTAR 2 scale and the GRADE tool were used to evaluate the quality of the report, the quality of the methodology, and the quality of the evidence, respectively. The quantitative results of the included systematic review/meta-analysis were analyzed comprehensively.
RESULTS
2
A total of 18 systematic reviews/meta-analyses were included. PRISMA 2020 stated that 3 reports were complete, 13 reports had partial information defects, and 2 reports had serious information defects. The results of the AMSTAR 2 scale evaluation showed that 4 literature had low methodological quality, and 14 literature had very low methodological quality. GRADE tool evaluation results showed that there were 106 outcome indicators, including 34 intermediate-quality evidence accounted for 32.1%, 51 poor-quality evidence accounted for 48.1%, 21 very poor-quality evidence accounted for 19.8%, and there was no high-quality evidence. Comprehensive analysis of quantitative results of various outcome indicators showed that TG had definite improvement effects on the total effective rate of DKD, 24-hour urinary protein quantity and serum albumin, and the adverse drug reactions were different in every study.
CONCLUSIONS
2
The efficacy of TG in the treatment of DKD is relatively accurate, safety still needs to be paid attention to, and future studies with larger sample size need to be verified.
糖尿病肾病雷公藤多苷伞形综述疗效安全性
Tripterygium glycosidesumbrella reviewefficacysafety
中华医学会糖尿病学分会微血管并发症学组. 中国糖尿病肾脏疾病防治临床指南[J]. 中华糖尿病杂志,2019,11(1):15-28.
The Microvascular Complications Group of Chinese Diabetes Association. Chinese clinical practice guideline of diabetic kidney disease[J]. Chin J Diabetes,2019,11(1):15-28.
PERKOVIC V,JARDINE M J,NEAL B,et al. Canagliflozin and renal outcomes in type 2 diabetes and nephropathy[J]. N Engl J Med,2019,380(24):2295-2306.
北京大学医学系糖尿病肾脏病专家共识协作组. 糖尿病肾脏病诊治专家共识[J]. 中华医学杂志,2020,100(4):247-260.
Peking University Department of Medicine Diabetic Nephrology Expert Consensus Collaborative Group. Diabetic nephropathy expert consensus[J]. Natl Med J China,2020,100(4):247-260.
梁艳,孙蔚楠,张宏,等. 雷公藤多苷片联合缬沙坦治疗慢性肾小球肾炎合并高血压患者的效果[J]. 中国临床药理学杂志,2022,38(21):2536-2540.
LIANG Y,SUN W N,ZHANG H,et al. Effect of Tripte- rygium wilfordii polyglycoside tablets combined with valsartan in patients with chronic glomerulonephritis and hypertension[J]. Chin J Clin Pharmacol,2022,38(21):2536-2540.
中华医学会肾脏病学分会专家组. 糖尿病肾脏疾病临床诊疗中国指南[J]. 中华肾脏病杂志,2021,37(3):255-304.
Expert Group of Chinese Society of Nephrology. Chinese guidelines for diagnosis and treatment of diabetic kidney disease[J]. Chin J Nephrol,2021,37(3):255-304.
李晶芳,韩蕊,殷宏庆,等. 雷公藤治疗肾脏疾病及其不良反应的研究进展[J]. 中国实验方剂学杂志,2021,27(14):229-234.
LI J F,HAN R,YIN H Q,et al. Tripterygium wilfordii in treatment of kidney diseases and its toxic and side effect:a review[J]. Chin J Exp Tradit Med Formulae,2021,27(14):229-234.
王源,赵班,刘莉莉,等. 雷公藤多苷治疗糖尿病肾病的研究进展[J]. 中国心血管杂志,2021,26(2):193-196.
WANG Y,ZHAO B,LIU L L,et al. Progress of Triptery-gium glycosides in the treatment of diabetic nephropathy[J]. Chin J Cardiovasc Med,2021,26(2):193-196.
孙重阳,张浩然,刘晓玉,等. 伞形综述:选择与应用最佳综合证据的循证实践[J]. 中国循证医学杂志,2022,22(5):609-614.
SUN C Y,ZHANG H R,LIU X Y,et al. Umbrella review:evidence-based practice for selecting and applying the best synthesis of evidence[J]. Chin J Evid-based Med,2022,22(5):609-614.
MOHER D,LIBERATI A,TETZLAFF J,et al. Preferred reporting items for systematic reviews and meta-analyses:the PRISMA statement[J]. PLoS Med,2009,6(7):e1000097.
陶欢,杨乐天,平安,等. 随机或非随机防治性研究系统评价的质量评价工具AMSTAR 2解读[J]. 中国循证医学杂志,2018,18(1):101-108.
TAO H,YANG L T,PING A,et al. Interpretation of AMSTAR 2:a critical appraisal tool for systematic reviews that include randomized or non-randomized studies of healthcare interventions[J]. Chin J Evid-based Med,2018,18(1):101-108.
曾宪涛,冷卫东,李胜,等. 如何正确理解及使用GRADE系统[J]. 中国循证医学杂志,2011,11(9):985-990.
ZENG X T,LENG W D,LI S,et al. How to understand and use GRADE system correctly a briefly outline[J]. Chin J Evid-based Med,2011,11(9):985-990.
吴蔚桦,汪汉,张茂平,等. 雷公藤多甙治疗糖尿病肾病的系统评价[J]. 中国循证医学杂志,2010,10(6):693-699.
WU W H,WANG H,ZHANG M P,et al. Effects of Tripterygium on diabetic nephropathy:a systematic review[J].Chin J Evid-based Med,2010,10(6):693-699.
朱国双,王岚,龙清华,等. 雷公藤多苷对比RAAS阻滞剂治疗糖尿病肾脏病有效性和安全性的Meta分析[J]. 临床肾脏病杂志,2019,19(10):727-733.
ZHU G S,WANG L,LONG Q H,et al. Meta-analysis of the efficacy and safety of Tripterygium glycosides versus RAAS blocker in the treatment of diabetic kidney disease[J]. Clin Nephrol,2019,19(10):727-733.
陈欢,詹菊,罗敏,等. 雷公藤多苷对糖尿病肾病炎症因子的影响和安全性的Meta分析[J]. 海峡药学,2020,32(10):102-107.
CHEN H,ZHAN J,LUO M,et al. Meta-analysis of the effects and safety of Tripterygium glycosides on inflammatory factors in diabetic nephropathy[J]. Strait Pharm J,2020,32(10):102-107.
程亚清,曲海顺,张献之,等. 雷公藤多苷辅助治疗糖尿病肾病的Meta分析[J]. 中国中西医结合肾病杂志,2022,23(2):133-139.
CHENG Y Q,QU H S,ZHANG X Z,et al. Meta-analysis of Tripterygium glycosides in the adjuvant treatment of diabetic nephropathy[J]. Chin J Integr Tradit West Nephrol,2022,23(2):133-139.
刘奎,张媛. 雷公藤多苷联合ACEI/ARB类药物治疗糖尿病肾病有效性和安全性系统评价[J]. 中医药临床杂志,2019,31(11):2086-2091.
LIU K,ZHANG Y. Systematic evaluation of efficacy and safety of Tripterygium wilfordii polyglycosides combined with ACEI/ARB drugs in the treatment of diabetic nephropathy[J]. Clin J Tradit Chin Med,2019,31(11):2086-2091.
黄静,张继强,陈峥,等. 雷公藤多苷治疗糖尿病肾病Ⅳ期患者疗效的系统评价[J]. 中国中药杂志,2015,40(15):3100-3109.
HUANG J,ZHANG J Q,CHEN Z,et al. Systematic evaluation for efficacy of Tripterygium glycosides in trea- ting diabetic nephropathy stage Ⅳ[J]. China J Chin Mater Med,2015,40(15):3100-3109.
张梦久,柳红芳,郭燕,等. 雷公藤多苷治疗糖尿病肾脏病临床疗效及安全性的Meta分析[J]. 医学综述,2020,26(9):1828-1836.
ZHANG M J,LIU H F,GUO Y,et al. Clinical efficacy and safety of Tripterygium glycosides in diabetic kidney disease:a meta-analysis[J]. Med Recapitul,2020,26(9):1828-1836.
谢海英,李青华,何剑零,等. 雷公藤多苷治疗早中期糖尿病肾病的系统评价[J]. 中国中西医结合肾病杂志,2012,13(6):536-537.
XIE H Y,LI Q H,HE J L,et al. Systematic evaluation of Tripterygium glycosides in the treatment of early and middle stage diabetic nephropathy[J]. Chin J Integrat Traditi West Nephrol,2012,13(6):536-537.
戴骁意,孙沛霖,周思遥,等. 联合应用雷公藤多苷治疗Ⅳ期糖尿病肾病的Meta分析[J]. 浙江临床医学,2018,20(8):1385-1388.
DAI Y X,SUN P L,ZHOU S Y,et al. Meta-analysis of combined Tripterygium glycosides in treatment of stage Ⅳ diabetic nephropathy[J]. Zhejiang Clin Med J,2018,20(8):1385-1388.
吴宇,张铮,方锦颖,等. 中药免疫抑制剂联合血管紧张素转化酶抑制剂/血管紧张素Ⅱ受体拮抗剂治疗早中期糖尿病肾病有效性和安全性的Meta分析[J]. 中国全科医学,2021,24(24):3101-3109.
WU Y,ZHANG Z,FANG J Y,et al. Effectiveness and safety of immunosuppressive agents derived from Chinese medicine with ACEI/ARB in early- and middle-stage diabetic nephropathy:a meta-analysis[J]. Chin Gen Prac,2021,24(24):3101-3109.
WU X,HUANG Y Y,ZHANG Y,et al. Efficacy of Tripte- rygium glycosides combined with ARB on diabetic nephropathy:a meta-analysis[J]. Biosci Rep,2020,40(11):BSR20202391.
GUO H B,PENG J Q,WANG X,et al. Efficacy of Tripte- rygium glycosides for diabetic nephropathy:a meta-analysis of randomized controlled trials[J]. BMC Nephrol,2021,22(1):304.
REN D J,ZUO C,XU G S. Clinical efficacy and safety of Tripterygium wilfordii Hook in the treatment of diabetic kidney disease stage Ⅳ:a meta-analysis of randomized controlled trials[J]. Medicine,2019,98(11):e14604.
HONG Y,GUI Z H,CAI X P,et al. Clinical efficacy and safety of Tripterygium glycosides in treatment of stage Ⅳ diabetic nephropathy:a meta-analysis[J]. Open Med,2016,11(1):611-617.
YE W C,YE J Z,ZHENG C,et al. Combination therapy of Tripterygium glycosides plus valsartan in diabetic nephropathy treatment:a systematic review and meta-analysis[J]. Chin Herb Med,2019,11(2):222-230.
WANG Y,HAN M,PEDIGO C E,et al. Combination of oral Tripterygium glycosides and angiotensin Ⅱ receptor blockers for treatment of clinical stage diabetic kidney disease:a systematic review and meta-analysis of rando- mized controlled trials[J]. Eur J Integr Med,2020,39:101197.
LI Y Z,MIAO R P,LIU Y X,et al. Efficacy and safety of Tripterygium glycoside in the treatment of diabetic nephropathy:a systematic review and meta-analysis based on the duration of medication[J]. Front Endocrinol,2021,12:656621.
梁新华,樊平. 雷公藤多苷片对糖尿病肾脏病变的临床疗效系统评价[J]. 山西医科大学学报,2016,47(8):751-755.
LIANG X H,FAN P. Systematic evaluation of clinical efficacy of Tripterygium wilfordii polyglycoside tablets in treating diabetic renal lesions[J]. J Shanxi Med Univ,2016,47(8):751-755.
赏石丽,孙紫娟,毕莉娜,等. 糖尿病肾病患者发生贫血的影响因素研究[J]. 中国全科医学,2022,25(12):1464-1469.
SHANG S Y,SUN Z J,BI L N,et al. Influencing factors of anemia in patients with diabetic kidney disease[J]. Chin Gen Prac,2022,25(12):1464-1469.
王爱媛,张婷,李春双,等. 糖尿病肾病患者血CD64、Alb、IL-6表达及其与合并肺部感染的关系和预后影响因素[J]. 中国老年学杂志,2022,42(3):547-550.
WANG A Y,ZHANG T,LI C S,et al. Expression of CD64,Alb,IL-6 in blood of diabetic nephropathy patients and their relationship with pulmonary infection and prognostic factors[J]. Chin J Gerontol,2022,42(3):547-550.
HU Y S,ZHOU X X,SHI H,et al. The effect of Tripte- rygium glucoside tablet on pharmacokinetics of losartan and its metabolite EXP3174 in rats[J]. Biomed Chromatogr,2017,31(10):324-328.
朱奕陶,刘芳. 雷公藤制剂治疗糖尿病肾病的研究进展[J]. 重庆医学,2022,51(14):2510-2514.
ZHU Y T,LIU F. Effects and risks of different Tripte- rygium preparations in treatment of diabetic nephropathy[J]. Chongqing Med,2022,51(14):2510-2514.
吴静静,任献青,苏杭,等. 基于CiteSpace对雷公藤多苷研究趋势及热点的可视化分析[J]. 中国药事,2022,36(2):170-178.
WU J J,REN X Q,SU H,et al. Visualized analysis of research trends and hotspots of Tripterygium wilfordii glycosides based on CiteSpace[J]. Chin Pharm Aff,2022,36(2):170-178.
杨丽,庞洁玉,段雪萍,等. 雷公藤多苷治疗糖尿病肾脏疾病作用机制概述[J]. 实用中医药杂志,2022,38(6):1069-1072.
YANG L,PANG J Y,DUAN X P,et al. Overview of mechanism of action of Tripterygium glycosides in treating diabetic kidney disease[J]. J Pract Tradit Chin Med,2022,38(6):1069-1072.
0
Views
5
下载量
0
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution