Yi-Jia Jiang, Mao-Ying Wei, Wen-Hua Zhang, Dan Yin, Yi-Ting Tang, Wei-Yu Jia, Jing-Yi Guo, Ai-Jing Li, Yan-Bing Gong
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A total of 323 RCTs were included, reporting 199 outcome indicators with the frequency of 3 744 in seven indicator domains: TCM syndromes(196 times, 5.24%), symptoms and signs(275 times, 7.35%), physical and chemical examinations(2 820 times, 75.32%), safety events(422 times, 11.27%), long-term prognosis(21 times, 0.56%), quality of life(9 times, 0.24%), and economic evaluation(1 time, 0.02%). The three most frequently applied outcome indicators were total clinical response rate(268 times, 82.97%), serum creatinine(251 times, 77.71%), and urea nitrogen(206 times, 63.78%). The outcomes in the studies of TCM treatment of DKD had the limitations of high risk of bias, lack of standardization of TCM syndromes and efficacy evaluation, neglect of endpoint indicators, large differences in endpoint indicators and time points of measurement, unclear primary and secondary outcomes, few application of long-term prognosis, quality of life, and economic indicators, and insufficient reporting of safety events. In the future, efforts should be made to actively promote the construction of COS in the studies about the TCM treatment of DKD and enhance the quality of the clinical studies.</p>","PeriodicalId":52437,"journal":{"name":"Zhongguo Zhongyao Zazhi","volume":"49 24","pages":"6813-6824"},"PeriodicalIF":0.0000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[Outcomes in randomized controlled trials of traditional Chinese medicine in treatment of diabetic kidney disease].\",\"authors\":\"Yi-Jia Jiang, Mao-Ying Wei, Wen-Hua Zhang, Dan Yin, Yi-Ting Tang, Wei-Yu Jia, Jing-Yi Guo, Ai-Jing Li, Yan-Bing Gong\",\"doi\":\"10.19540/j.cnki.cjcmm.20240826.502\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>This study systematically analyzed the current status of outcomes in randomized controlled trial(RCT) of traditional Chinese medicine(TCM) treatment of diabetic kidney disease(DKD), aiming to provide a reference for constructing the core outcome set(COS) of TCM treatment of DKD. 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引用次数: 0
摘要
本研究系统分析中医药治疗糖尿病肾病(DKD)随机对照试验(RCT)结局的现状,旨在为构建中医药治疗糖尿病肾病(DKD)的核心结局集(COS)提供参考。检索2019年1月至2024年3月发表的中医药治疗DKD的临床随机对照试验,检索数据库为:CNKI、万方、维普、中国医学信息网、PubMed、Cochrane Library和Web of Science。对偏倚风险进行评估,并对结果指标进行定性分析。共纳入323项随机对照试验,共报告199项结局指标,频率为3 744次,分为7个指标域:中医证候(196次,5.24%)、症状体征(275次,7.35%)、理化检查(2 820次,75.32%)、安全事件(422次,11.27%)、长期预后(21次,0.56%)、生活质量(9次,0.24%)、经济评价(1次,0.02%)。应用频率最高的三个结局指标为总临床缓解率(268次,82.97%)、血清肌酐(251次,77.71%)和尿素氮(206次,63.78%)。中医药治疗DKD的研究结果存在偏倚风险高、中医证候及疗效评价缺乏标准化、忽视终点指标、终点指标及测量时间差异大、主次结局不明确、长期预后、生活质量、经济指标应用较少、安全事件报道不足等局限性。今后应积极推进中医治疗DKD研究中COS的构建,提高临床研究质量。
[Outcomes in randomized controlled trials of traditional Chinese medicine in treatment of diabetic kidney disease].
This study systematically analyzed the current status of outcomes in randomized controlled trial(RCT) of traditional Chinese medicine(TCM) treatment of diabetic kidney disease(DKD), aiming to provide a reference for constructing the core outcome set(COS) of TCM treatment of DKD. The clinical RCTs of TCM treatment of DKD that were published from January 2019 to March 2024 were retrieved from seven databases: CNKI, Wanfang, VIP, SinoMed, PubMed, Cochrane Library, and Web of Science. The risk of bias was assessed and outcome indicators were qualitatively analyzed. A total of 323 RCTs were included, reporting 199 outcome indicators with the frequency of 3 744 in seven indicator domains: TCM syndromes(196 times, 5.24%), symptoms and signs(275 times, 7.35%), physical and chemical examinations(2 820 times, 75.32%), safety events(422 times, 11.27%), long-term prognosis(21 times, 0.56%), quality of life(9 times, 0.24%), and economic evaluation(1 time, 0.02%). The three most frequently applied outcome indicators were total clinical response rate(268 times, 82.97%), serum creatinine(251 times, 77.71%), and urea nitrogen(206 times, 63.78%). The outcomes in the studies of TCM treatment of DKD had the limitations of high risk of bias, lack of standardization of TCM syndromes and efficacy evaluation, neglect of endpoint indicators, large differences in endpoint indicators and time points of measurement, unclear primary and secondary outcomes, few application of long-term prognosis, quality of life, and economic indicators, and insufficient reporting of safety events. In the future, efforts should be made to actively promote the construction of COS in the studies about the TCM treatment of DKD and enhance the quality of the clinical studies.