Page 109 - 《中国药房》2023年23期

·循证药学·

雷公藤多苷治疗糖尿病肾病的系统评价再评价
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王屹菲 ，周 敏 ，喻 嵘 （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）
中图分类号 R587.2；R969.3 文献标志码 A 文章编号 1001-0408（2023）23-2915-07
DOI 10.6039/j.issn.1001-0408.2023.23.18

摘 要 目的 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 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 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 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。
关键词 糖尿病肾病；雷公藤多苷；伞形综述；疗效；安全性

Reevaluation of systematic evaluation of Tripterygium glycosides in the treatment of diabetic kidney disease
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WANG Yifei ，ZHOU Min ，YU Rong （1. Dept. of Endocrinology， the First Affiliated Hospital of Hunan
University of Chinese Medicine， Changsha 410007， China；2. School of Graduate， Hunan University of Chinese
Medicine， Changsha 410208， China）
ABSTRACT OBJECTIVE 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 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 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 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.
KEYWORDS diabetic kidney disease； Tripterygium glycosides； umbrella review； efficacy； safety

糖尿病肾病（diabetic kidney disease，DKD）是糖尿
Δ 基金项目 国家自然科学基金项目（No.U21A20411）；国家自然 病（diabetes mellitus，DM）常见并发症之一，已超过肾
科学基金面上项目（No.82074400）；湖南中医药大学研究生创新课题 小球肾炎成为我国住院患者慢性肾病（chronic kidney
（No.2022CX144） disease，CKD）的首要病因 ，同时也是导致终末期肾病
[1]
＊第一作者 硕士研究生。研究方向：中医药防治内分泌疾病。
[2]
（end-stage renal disease，ESRD）的首要病因 ，该病的临
E-mail：381596396@qq.com
# 通信作者 教授，博士生导师，博士。研究方向：中医药防治内分 床特征为尿白蛋白/肌酐比值≥30 mg/g和（或）肾小球滤
2
[1]
泌疾病。E-mail：yurong8072@qq.com 过率低于 60 mL/（min·1.73 m）持续超过 3 个月 ，控制
中国药房 2023年第34卷第23期 China Pharmacy 2023 Vol. 34 No. 23 · 2915 ·