摘要
目的:系统评价雷公藤(Tripterygium wilfordii,TW)治疗成人特发性膜性肾病(Idiopathic membranous nephropathy,IMN)的疗效及其减少24 h尿蛋白定量(24hUTP)的效果。方法:通过系统检索中国知网(CNKI)、维普(VIP)、万方(Wanfang)、中国生物医学数据库(CBM)等中文数据库及PubMed、Embase、Web of Science、The Cochrane Central Register of Controlled Trials(CENTRAL)等英文数据库以及中国临床试验注册中心和美国临床试验注册中心注册的未发表的但临床试验已经完成的结果,收集雷公藤联合常规西医疗法或免疫抑制药物治疗成人INM的随机对照试验。筛选文献、提取资料和评价研究质量,采用RevMan5.4软件或Stata/SE 15.1软件进行meta分析,观察治疗后总缓解率及24 hUTP下降水平。结果:共纳入14个研究,涉及936例患者,经过治疗干预措施含雷公藤的试验组总缓解率优于对照组[RR=1.27,95%CI(1.20-1.36),Z=7.45,P<0.05],降低24 hUTP(MD=1.16,95%CI(-1.40,-0.93),Z=9,78(P<0.00001))方面优于对照组。结论:雷公藤联合常规西医疗法或免疫抑制药物治疗IMN在减少24 hUTP、提高总有效率方面显示出一定优势,但因纳入研究的证据级别较低,结论尚需高质量的多中心、大样本前瞻性随机对照试验证实。
Objective:To systematically evaluate the efficacy of Tripterygium wilfordii(TW)in the treatment of adult Idiopathic membranous nephropathy(IMN)and its effect of reducing 24-hour urinary protein quantification(24 hUTP).Method:Chinese databases such as CNKI,VIP,Wanfang,CBM,English databases such as PubMed,Embase,Web of Science,The Cochrane Library,as well as unpublished results of completed clinical Trials registered in Chinese and American clinical trial registries were searched systematically.We collected a randomized controlled trial of tripterygium wilfordii combined with conventional Western medicine or immunosuppressive agents in the treatment of adults with IMN.Literature was screened,data were extracted and study quality was evaluated.Meta-analysis was performed using RevMan5.4 software or Stata/SE 15.1 software to observe the total remission rate of the disease and the quantitative reduction level of 24 hUTP after treatment.Results:A total of 14 studies were included,involving 936 patients.After treatment,the total remission rate of the experimental group containing tripterygium wilfordii was better than that of the control group[RR=1.27,95%CI(1.20-1.36),Z=7.45,P<0.05],and the reduction of 24 hUTP level(MD=1.16,95%CI(-1.40,-0.93),Z=9,78(P<0.00001))was better than that of the control group.Conclusion:Tripterygium wilfordii combined conventional western medicine therapy or immunosuppressive drugs to treat idiopathic membranous nephropathy in 24 h UTP,reduce showed certain advantages,improve the total effective rate.But included in the study of the low level of evidence,the conclusion still needs high quality multicenter,large sample,prospective randomized controlled trial to further confirm.
作者
相敏
鲁凌飞
李雨彦
卢建东
熊国良
XIANG Min;LU Ling-fei;LI Yu-yan;LU Jian-dong;XIONG Guo-liang(The Fourth Clinical School of Guangzhou University of Traditional Chinese Medicine,Shenzhen 518033,China)
出处
《内蒙古中医药》
2022年第10期163-168,共6页
Inner Mongolia Journal of Traditional Chinese Medicine
基金
深圳市科技创新委员会重点项目(NO.JCYJ20180507183842516)
深圳“医疗卫生三名工程”《天津市中医药研究院张大宁国医大师中医药防护肾脏疾病团队》项目(SZSM201512040)
关键词
雷公藤
特发性膜性肾病
META分析
Tripterygium wilfordii
idiopathic membranous nephropathy
Meta analysis
