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目的:系统评价银杏叶提取物对糖尿病肾病患者尿微量白蛋白和肾功能的影响。方法:计算机检索Pubmed医学数据库、中国生物医学文献数据库(CBM),中文科技期刊全文数据库(CNKI),维普中文数据库(VIP)和万方数据库等,以常规治疗为对照组,以在常规治疗基础上加用银杏叶提取物对糖尿病肾病患者尿微量白蛋白和肾功能影响的随机对照研究,由2位研究者按照纳入与排除标准筛选文献、提取资料和评价纳入研究的方法学质量后,采用Rev Man 5.2软件进行Meta分析。结果:共纳入16项随机对照试验,1 212例患者。Meta分析结果显示,与对照组相比,试验组更能减小尿白蛋白排泄率(UAER)[SMD=1.00,95%CI(0.70,1.30),P<0.01]和24 h尿蛋白定量[SMD=1.00,95%CI(0.70,1.30),P<0.01];不能显著减少血清肌酐[SMD=0.11,95%CI(-0.03,0.26),P>0.05]。结论:银杏叶提取物能显著减小糖尿病肾病患者尿微量白蛋白,但对肾功能无显著性改善。受纳入研究方法学质量限制,该结论有待大样本、高质量的RCT进一步验证。
Objective: To systematically evaluate the effects of Ginkgo biloba extract on urinary albumin and renal function in patients with diabetic nephropathy. Methods: Pubmed medical database, CBM, CNKI, VIP database and Wanfang database were searched by computer. The patients in control group were treated with routine therapy A randomized, controlled study of the effect of Ginkgo biloba extract on urinary albumin and renal function in patients with diabetic nephropathy was conducted by two investigators who screened the literature for inclusion and exclusion criteria, extracted data, and evaluated the methodological quality of the included studies Rev Man 5.2 software for meta-analysis. Results: A total of 16 randomized controlled trials were included, with 1 212 patients. Meta-analysis showed that compared with the control group, the experimental group was more able to reduce the urinary albumin excretion rate (UAER) [SMD = 1.00,95% CI (0.70,1.30), P <0.01] SMD = 1.00,95% CI (0.70,1.30), P <0.01]; no significant reduction of serum creatinine [SMD = 0.11,95% CI (-0.03,0.26), P> 0.05]. Conclusion: Ginkgo biloba extract can significantly reduce urinary albumin in patients with diabetic nephropathy, but no significant improvement in renal function. Subject to the quality limitations of research methodology, this conclusion needs to be further validated by large samples, high quality RCTs.