目的：系统评价复方血栓通胶囊联合血管紧张素转化酶抑制剂／血管紧张素Ⅱ受体拮抗剂（ angiotensin-converting enzyme inhibitors，ACEI／angiotensin receptor blockers，ARB）治疗早期糖尿病肾病（ diabetic kidney disease，DKD）的疗效。方法：计算机检索中国期刊全文数据库、万方数据库和维普数据库，数据库建库起至2016年5月3日期间，收集复方血栓通胶囊联合ACEI／ARB治疗早期DKD的随机对照试验（ randomized controlled trial，RCT），同时辅以手工检索，评价纳入研究质量，合并结果进行Meta 分析。结果：共纳入6项RCT，合计532例患者。 Meta分析结果显示，观察组治疗后在提高临床总有效率（ RR＝1.33，95％CI＝1.17～1.52，P＜0.00001），降低尿白蛋白排泄率（ MD ＝－21.03，95％CI ＝－31.75～－10.31， P＝0.0001）、全血高切黏度（ MD ＝－1.06，95％CI＝－1.46～－0.65，P＜0.00001）、全血低切黏度（MD＝－1.78，95％CI＝－3.43～－0.12，P＝0.04）、总胆固醇（MD＝－0.98，95％CI＝－1.67～－0.29，P＝0.006）、三酰甘油（MD＝－0.40，95％CI＝－0.67～－0.13，P＝0.004）和提高高密度脂蛋白胆固醇（ MD＝0.32，95％CI＝0.10～0.55，P＝0.005）等方面均优于对照组，差异有统计学意义；2组患者空腹血糖（MD＝－0.34，95％CI＝－1.14～0.45，P＝0.40）、餐后2 h血糖（MD＝－0.84，95％CI＝－2.67～0.99，P＝0.37）、糖化血红蛋白（MD＝－0.02，95％CI＝－0.19～0.15，P＝0.37）、尿素氮（MD＝－0.16，95％CI＝－0.59～0.27，P＝0.46）、血肌酐（MD＝－9.19，95％CI＝－8.72～3.55，P＝0.16）和低密度脂蛋白胆固醇（MD＝－0.60，95％CI＝－1.58～－0.39，P＜0.23）等方面比较，差异无统计学意义。结论：复方血栓通胶囊联合ACEI／ARB治疗早期糖尿病肾病的疗效优于单用ACEI／ARB。%OBJECTIVE:To systematically review the efficacy of compound Xueshuantong capsules combined with angiotensin-converting enzyme inhibitors( ACEI)/angiotensin receptor blockers( ARB) in treatment of diabetic kidney disease( DKD) .METHODS: CJFD, VIP and Wanfang Database were retrieved to collect the randomized controlled trials( RCT) about the efficacy of compound Xueshuantong Capsules combined with ACRI/ARB in treatment of DKD till May.3rd , 2016, manual retrieval was adopted.Quality evaluation and Meta-analysis of included literatures were conducted.RESULTS: A total of 6 RCTs were included, involving 532 cases.Results of Meta-analysis showed that compound Xueshuantong capsules combined with ACEI/ARB ( test group) was better than that of ACEI/ARB( control group) in increasing clinical total effective rate(RR=1.33,95%CI=1.17-1.52,P<0.000 01), reducing UAER ( MD =-21.03 , 95%CI =-31.75--10.31 , P =0.000 1 ) , whole blood high-shear viscosity ( MD =-1.06 , 95%CI=-1.46--0.65,P<0.000 01), whole blood low-shear viscosity(MD=-1.78,95%CI=-3.43--0.12, P=0.04), TC (MD =-0.98,95%CI =-1.67--0.29,P =0.006), TG (MD =-0.40,95%CI =-0.67--0.13,P=0.004) and increasing HDL-C (MD=0.32,95%CI=0.10-0.55,P=0.005), there were statistically significant differences between two groups.And there was no significant difference in the FBG ( MD =-0.34, 95%CI=-1.14-0.45,P =0.40), PBG (MD =-0.84,95%CI =-2.67-0.99,P =0.37), HbA1c (MD =-0.02,95%CI=-0.19-0.15,P=0.37), BUN (MD=-0.16,95%CI=-0.59-0.27,P=0.46), Scr (MD=-9.19,95%CI=-8.72-3.55,P=0.16) and LDL-C (MD=-0.60,95%CI=-1.58--0.39,P=0.23) between two groups.CONCLUSIONS: The efficacy of compound Xueshuantong capsules combined with ACEI/ARB is better than only ACEI/ARB in treatment of DKD.
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