目的:系统评价中药汤剂辅助治疗糖尿病肾病的有效性和安全性。方法:在PubMed中进行全面搜索,WebofScience,科克伦图书馆,Embase,中国国家知识基础设施(CNKI),和万方数据库,涵盖2013年1月至2023年7月期间。搜索仅限于在过去十年中进行的随机对照试验(RCT),该试验研究了使用中药汤剂作为糖尿病肾病的辅助治疗方法。对照组给予西医治疗,干预组在常规治疗的基础上加用中药汤剂。采用尾注和Excel进行文献管理和数据组织,使用Revman5.3和Stata16软件进行分析。结果:本研究纳入了66个RCTs,涉及6,951名参与者。中药汤剂辅助治疗糖尿病肾病的临床疗效明显高于对照组(OR=3.12,95%CI[2.70,3.60],I2=0%,p<0.00001)。干预组与对照组的不良事件发生率无显著差异(OR=0.94,95%CI[0.60,1.48],I2=0%,p=0.94)。根据肾功能和血糖指标的次要结局,与对照组相比,干预组显示出更好的治疗效果。最常用的中医类别是补药,活血药,收敛药,利尿药,清热药,和泻药。其中,前五名常用中药是黄芪[豆科;黄芪](58次),丹参[唇齿科;丹参](42次),山药[山药科;山药](38次),Poriacocos(Schw。)狼[猪科;Poria](38次),和山茱萸Siebold&Zucc。[山茱萸科;山茱萸](35倍)。结论:中药汤剂联合西药治疗糖尿病肾病可提高临床疗效,与单纯西药相比,最终排版文章没有达到更好的治疗效果,没有重大风险。系统审查注册:https://www。crd.约克。AC.uk/PROSPERO/#recordDetails,标识符[CRD42022529144]。
Objective: This study aimed to assess the efficacy and safety of traditional Chinese medicine decoction as an adjunctive treatment for diabetic nephropathy in systematic evaluations. Methods: A comprehensive search was conducted in PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), and Wanfang databases, covering the period from January 2013 to July 2023. The search was restricted to randomized controlled trials (RCTs) conducted within the past decade that investigated the use of TCM decoction as an adjunctive treatment for diabetic nephropathy. The control group received western medicine treatment, while the intervention group received TCM decoction in addition to the conventional treatment. Endnote and Excel were employed for literature management and data organization, and Revman 5.3 and Stata 16 software were used for the analyses. Results: 66 RCTs involving 6,951 participants were included in this study. The clinical efficacy of TCM decoction as an adjunctive treatment for diabetic nephropathy was found to be significantly higher than that of the control group (OR = 3.12, 95% CI [2.70, 3.60], I2 = 0%, p < 0.00001). The incidence of adverse events did not differ significantly between the intervention group and the control group (OR = 0.94, 95% CI [0.60, 1.48], I2 = 0%, p = 0.94). According to the secondary outcomes of renal function and blood glucose indicators, the intervention group showed better therapeutic efficacy compared to the control group. The most frequently used TCM categories were tonifying medicine, blood-activating medicine, astringent medicine, diuretic medicine, heat-clearing medicine, and laxative medicine. Among them, the top five frequently used Chinese medicine were Astragalus mongholicus Bunge [Fabaceae; Astragali mongholici radix](58 times), Salvia miltiorrhiza Bunge [Lamiaceae; Radix et rhizoma salviae miltiorrhizae] (42 times), Dioscorea oppositifolia L. [Dioscoreaceae; Dioscoreae rhizoma] (38 times), Poria cocos (Schw.) Wolf [Polyporaceae; Poria] (38 times), and Cornus officinalis Siebold & Zucc. [Cornaceae; Corni fructus] (35 times). Conclusion: The combined use of TCM decoction with western medicine in the treatment of diabetic nephropathy can enhance clinical effectiveness and 2 This is a provisional file, not the final typeset article achieve superior therapeutic effects in comparison to western medicine alone, without significant risks. Systematic
Review Registration: https://www.crd.york.ac.uk/PROSPERO/#recordDetails, identifier [CRD42022529144].