CAJ | 학술논문

目的：评估冬虫夏草制剂治疗急性肾损伤的效果和潜在的副作用，为临床实践提供证据。方法用相关的检索词检索包括MEDLINE、EMBASE、CENTRAL的英文数据库和包括CNKI、CBM、万方、和维普的中文数据库以及会议论文集、硕博士论文等文献库。提取数据，采用RevMan 5．0软件进行meta分析。结果本系统评价共纳入7个随机对照临床研究（共纳入601急性肾损伤患者）。所有研究方法学质量均较低。在试验组和对照组均应用常规治疗的基础上，比较了虫草制剂与空白对照在急性肾损伤患者中应用的临床效果。 Meta分析结果显示虫草制剂可以显著改善患者的血肌酐水平，缩短少尿期，提高尿渗透压（ P＜0．05）。同时显示了改善生存率和减少需要肾脏替代治疗的有益趋势。结论在常规治疗的基础上，虫草制剂应用于急性肾损伤患者，可以改善肾小球及肾小管功能，促进肾小管功能恢复，从而改善临床治疗效果。未来的临床研究需要较长的观察期以确定长期效果，并且需要较大样本、方法学更为完善的临床试验提供更为有力的证据。
목적：평고동충하초제제치료급성신손상적효과화잠재적부작용，위림상실천제공증거。방법용상관적검색사검색포괄MEDLINE、EMBASE、CENTRAL적영문수거고화포괄CNKI、CBM、만방、화유보적중문수거고이급회의논문집、석박사논문등문헌고。제취수거，채용RevMan 5．0연건진행meta분석。결과본계통평개공납입7개수궤대조림상연구（공납입601급성신손상환자）。소유연구방법학질량균교저。재시험조화대조조균응용상규치료적기출상，비교료충초제제여공백대조재급성신손상환자중응용적림상효과。 Meta분석결과현시충초제제가이현저개선환자적혈기항수평，축단소뇨기，제고뇨삼투압（ P＜0．05）。동시현시료개선생존솔화감소수요신장체대치료적유익추세。결론재상규치료적기출상，충초제제응용우급성신손상환자，가이개선신소구급신소관공능，촉진신소관공능회복，종이개선림상치료효과。미래적림상연구수요교장적관찰기이학정장기효과，병차수요교대양본、방법학경위완선적림상시험제공경위유력적증거。
Objective To evaluate the benefits and potential adverse effects of Cordyceps sinensis as an adjuvant immunosuppressive treatment in acute kidney injury.Methods English language database ( including MEDLINE, EMBASE and CENTRAL) in systematic review searched, using search terms relevant to this review.Chinese language databases ( including CNKI, CBM, WanFang and other resources) in systematic review also searched.It included all randomised controlled trials ( RCTs) and quasi-RCTs evaluating the benefits and potential side effects of Cordyceps sinensis for acute kidney injury, irrespective of blinding or publication language.An inclusion criterion was that immunosuppressive therapy baseline must be the same across arms in each study.Data were collected and analyzed by RevMan 5.0.Methodological risk of bias was assessed using the Cochrane risk of bias tool. Results This review included 7 RCTs (representing a total of 601 patients with acute kidney injury) that assessed the use of Cordyceps.Reporting of methods was incomplete in most studies.It conducted comparisons of Cordyceps versus no treatments on the base of same conventional treatment in both groups.Cordyceps for patients showed a favorable trends toward improving patient survival and reducing renal replace treatment, but the difference did not reach significance.However, Cordyceps significantly reduce the level of serum creatinine shorten the period of oliguria, and increase the osmotic pressure of urine.Conclusion On the base of same conventional treatment in both groups, compared with no treatment, Cordyceps significantly improves the functions of renal tubule and glomerulus.But long-term studies are needed to clarify any benefit-harm trade-off.Future studies also need to be appropriately sized and powered.