雷公藤多苷治疗糖尿病肾病的系统评价再评价
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篇名: 雷公藤多苷治疗糖尿病肾病的系统评价再评价
TITLE: Reevaluation of systematic evaluation of Tripterygium glycosides in the treatment of diabetic kidney disease
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、CochraneLibrary、Embase数据库中TG治疗DKD的系统评价/Meta分析,通过PRISMA2020声明、AMSTAR2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,PRISMA2020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;AMSTAR2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、24h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。
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.
期刊: 2023年第34卷第23期
作者: 王屹菲;周敏;喻嵘
AUTHORS: WANG Yifei,ZHOU Min,YU Rong
关键字: 糖尿病肾病;雷公藤多苷;伞形综述;疗效;安全性
KEYWORDS: diabetic kidney disease; Tripterygium glycosides; umbrella review; efficacy; safety
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