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近六年中医药治疗糖尿病肾脏病的临床研究证据图分析OA

Evidence mapping analysis of clinical research on TCM for diabetic kidney disease in recent six years

中文摘要英文摘要

采用证据图梳理近六年中医药治疗糖尿病肾脏病(DKD)的相关临床研究,系统评估该领域的证据现状,以期为现存问题及后续研究方向提供科学依据和决策参考.系统检索中国知网(CNKI)、万方(Wanfang)、维普(VIP)、中国生物医学文献服务系统(SinoMed)、PubMed、EMbase、Web of Science、Cochrane Library等数据库中医药治疗DKD的文献,经过多次筛选,共纳入310 篇文献,其中随机对照试验(RCTs)289 篇,系统评价/Meta分析13 篇,指南/专家共识8 篇.整体发文量呈上升趋势,其中干预方式以口服为主,疗程多在 2~3 个月,样本量集中在 50~100 例.涉及 30 种中药汤剂、39 种中成药,以参芪地黄汤、益肾化湿颗粒发文量最多.纳入中医证型以气阴两虚、脾肾两虚为主.结局指标纳入较多的有临床有效率、血糖相关、肾功能等指标,缺少对长期结局检测等问题.方法学质量评估方面,多数RCT在分配隐藏、盲法实施等存在严重缺陷,整体质量不高.系统评价/Meta分析的质量评估等级也均为"极低级".指南/专家共识整体质量尚可,在严谨性和临床应用等方面待进一步完善.后续应重视以上问题,提升临床研究质量,发挥中医药优势,为中医药防治DKD的临床决策提供更可靠的循证依据.

The study employed an evidence mapping approach to systematically review clinical research on TCM for diabetic kidney disease(DKD)over the past six years and evaluate the current state of evidence,aiming to provide a scientific basis and decision reference for current gaps and future research directions.A comprehensive literature search was conducted across databases including CNKI,Wanfang,VIP,SinoMed,PubMed,Web of Science,EMbase,and Cochrane Library,yielding 310 publications related to TCM treatment of DKD.These included 289 randomized controlled trials(RCTs),13 systematic reviews/Meta-analyses,and 8 guidelines/expert consensus documents.The analysis revealed an overall upward trend in publication volume,with oral administration being the predominant intervention method.Treatment durations were typically from two to three months,and sample sizes mostly ranged between 50-100 patients.A total of 30 different TCM decoctions and 39 Chinese patent medicines were investigated,with Shenqi Dihuang Decoction and Yishen Huashi Granules being the most frequently studied.The primary TCM syndrome patterns identified were Qi and Yin deficiency and spleen-kidney deficiency.Outcome indicators predominantly focused on clinical response rates,blood glucose-related indicators,and renal function parameters,with a notable lack of long-term outcome assessments.Methodological quality evaluation indicated significant shortcomings in RCT,particularly in allocation concealment and blinding,resulting in an overall low quality of evidence.Similarly,the systematic reviews/Meta-analyses were rated as"very low".In contrast,the guidelines and expert consensus documents demonstrated relatively acceptable quality,but there was room for further improvement in rigor and clinical application.The findings underscore the need for future research to address these methodological deficiencies,particularly by improving trial design and leveraging TCM advantages,so as to provide a more reliable evidence base for clinical decision-making in DKD prevention and treatment.

李然;董朋涛;高亚斌;李奥宇;王峥

河南中医药大学 第一附属医院 肾内科,河南 郑州 450000||河南中医药大学 第一附属医院肾脏病诊疗中心,河南 郑州 450000||河南中医药大学,河南 郑州 450046河南中医药大学 第一附属医院 肾内科,河南 郑州 450000||河南中医药大学 第一附属医院肾脏病诊疗中心,河南 郑州 450000||河南中医药大学,河南 郑州 450046河南中医药大学 第一附属医院 肾内科,河南 郑州 450000||河南中医药大学 第一附属医院肾脏病诊疗中心,河南 郑州 450000||中西医防治重大疾病河南省协同创新中心,河南 郑州 450000河南中医药大学 第一附属医院 肾内科,河南 郑州 450000||河南中医药大学 第一附属医院肾脏病诊疗中心,河南 郑州 450000||河南中医药大学,河南 郑州 450046河南中医药大学 第一附属医院 肾内科,河南 郑州 450000||河南中医药大学 第一附属医院肾脏病诊疗中心,河南 郑州 450000||中西医防治重大疾病河南省协同创新中心,河南 郑州 450000

糖尿病肾脏病中医药随机对照试验Meta分析证据图

diabetic kidney diseasetraditional Chinese medicinerandomized controlled trialMeta-analysisevidence map

《中国中药杂志》 2026 (4)

1172-1183,12

国家自然科学基金项目(82405343)河南省科技厅河南省科技攻关项目(232102310458)河南省中医药拔尖人才培养项目(2022ZYBJ08)河南省高等学校重点科研计划项目(25A360004)河南省中医药科学研究专项(2025ZY1008)

10.19540/j.cnki.cjcmm.20251110.501

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