■冬虫夏草(O.sinensis),子囊菌真菌的一个属,已在中国广泛用作膳食补充剂或自然疗法,并在各种疾病模型中以其免疫调节潜力进行了深入研究。它是各种生物活性化合物的丰富来源,用于治疗终末期肾病。这项具有临床证据的系统评价旨在强调O.Sinensis作为透析患者辅助治疗的有效性和安全性。
■对截至2024年4月31日的9个电子数据库进行了系统搜索,以进行相关研究。Cochrane偏倚风险工具用于评估研究质量。建议评估的分级,发展,并采用评估系统对证据的确定性进行评估。两名研究人员独立搜索了文献并评估了偏倚的风险。
■筛选后,最终纳入了35项随机对照试验(RCT),涉及2,914例患者。荟萃分析显示,使用O.sinensis可有效降低透析患者的以下结局:C反应蛋白(15RCTs,MD=-2.22,95%CI-3.24至-1.20;非常低的确定性证据);肌酐(22RCT,MD=1.33,95%CI-1.79至-0.87;非常低的确定性证据);血尿素氮(21RCTs,MD=-1.57,95%CI-2.07至-1.07;低确定性证据);。它还可以有效改善透析患者的以下结局:白蛋白(20RCTs,MD=-0.81,95%CI-1.21至-0.41;低确定性证据);血红蛋白(19RCTs,MD=-1.00,95%CI-1.43至-0.57;低确定性证据)。对照组药物不良反应发生率高于实验组(4RCT,MD=1.81,95%CI0.88-3.74)。
■目前的证据表明,接受O.sinensis辅助治疗的透析患者可以改善血液透析和腹膜透析患者的营养和微炎症状态以及肾功能。然而,一些局限性影响了我们研究结果的概括性.未来有必要进行高质量的研究来评估不同透析方式的CKD患者的死亡率。
■https://www.crd.约克。AC.uk/prospro/display_record.php?ID=CRD42022324508,注册号CRD42022324508。
UNASSIGNED: Ophiocordyceps sinensis (O. sinensis), a genus of ascomycete fungi, has been widedly used in
China as a dietary supplement or natural remedy and intensively studied in various disease models with its immunomodulatory potentials. It is a rich source of various bioactive compounds and used for treating end-stage renal disease. This systematic review with clinical evidence aimed to highlight the efficacy and safety of O. Sinensis as an adjuvant treatment for patients undergoing
dialysis.
UNASSIGNED: A systematic search through nine electronic databases up to 31 April 2024, was conducted for related studies. The Cochrane risk-of-bias tool was used to evaluate the quality of studies. The Grading of Recommendations Assessment, Development, and Evaluation system was used to assess the certainty of evidence. Two researchers independently searched the literature and evaluated the risk of bias.
UNASSIGNED: After the screening, 35 randomized controlled trials (RCTs) involving 2,914 patients were eventually included. The meta-analysis showed that using O. sinensis effectively reduced the following outcomes in patients undergoing dialysis: C-reactive protein (15RCTs, MD = -2.22, 95% CI -3.24 to -1.20; very low certainty evidence); creatinine (22RCTs, MD =1.33, 95% CI -1.79 to -0.87; very low certainty evidence); blood urea nitrogen (21RCTs, MD = -1.57, 95% CI -2.07 to -1.07; low certainty evidence);. It could also effectively improve the following outcomes in patients undergoing
dialysis: albumin (20RCTs, MD = -0.81, 95% CI -1.21 to -0.41; low certainty evidence); hemoglobin (19RCTs, MD = -1.00, 95% CI -1.43 to -0.57; low certainty evidence). The rate of adverse drug reactions was higher in the control group than in the experimental group (4RCTs, MD = 1.81, 95% CI 0.88-3.74).
UNASSIGNED: The current evidence indicates that patients with
dialysis receiving O. sinensis in the adjuvant treatment may improve nutritional and micro-inflammatory status and renal function for both hemodialysis and peritoneal
dialysis patients. However, some limitation affected the generalizability of our findings. High-quality studies evaluating mortality outcomes of patients with different dialytic modalities in CKD are warranted in future.
UNASSIGNED: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022324508, registration number CRD42022324508.