摘要
目的:运用循证医学方法评价中药联合环磷酰胺(CyclophosphaMide,CTX)治疗成人难治性肾病综合征(Refractory Nephropathy Syndrome,RNS)的疗效及安全性。方法:系统检索中国知网(CNKI)、万方数据库(WANFANG Data)、维普(VIP)、中国生物医学文献数据库(CBM)、PubMed、EMbase、The Cochrane Library等数据库。检索时间为2005-2020年的文献,依据纳入及排除标准,收集关于中药联合环磷酰胺(Cyclophamide,CTX)治疗成人RNS的随机对照试验(Randomized Controlled Trials,RCT)。根据Cochrane系统评价方法对文献进行质量评价。采用Review Manager 5.3软件进行Meta分析。结果:中药联合CTX组总有效率和完全缓解率方面显著高于对照组,差异有统计学意义。中药联合CTX组在降低24 h尿蛋白定量(24-hour Urine Protein,24 h Upro)、总胆固醇(Total Cholesterol,TC)、血肌酐(Serum Creatinine,Scr)及提高血浆白蛋白(Albumin,ALB)等方面均优于对照组,差异均有统计学意义。中药联合CTX组肝功能异常、感染、库欣综合征、消化道反应、白细胞减少、肾功能异常、血糖升高以及其他不良反应(脱发、少尿、痤疮、腰膝酸软等)的发生率显著低于对照组,差异有统计学意义。中药联合CTX组在降低复发率方面显著优于对照组,差异有统计学意义。结论:中药联合CTX治疗成人RNS的疗效及安全性优于单纯西医,但确切疗效仍需要更高质量的前瞻性研究加以证实。
Objective: The evidence-based medicine method was applied to evaluate the efficacy and safety of TCM medicine plus CTX on adult refractory nephrotic syndrome. Methods: The literatures on RCTs of treating adult refractory nephrotic syndrome with TCM medicine plus CTX from 2005 to June 2020 in CNKI, WAN-Fang Data, VIP, CBM, PubMed, EMbase, The Cochrane Library and other databases was retrieved systematacially. The quality of the included literatures was evaluated according to the Cochrane systematic evaluation method. A Meta-analysis was executed by Review Manager 5.3 software. Results: The total efficiency and completed remission in the combined group were significantly higher than the control group, and the differences were statistically significant. The combined group is superior to the control group in reducing the 24 h Upro, TC, and Scr, and increasing ALB, and the differences were statistically significant. The incidence of abnormal liver function, infection, Cushing’s syndrome, gastrointestinal reaction, leukopenia, abnormal renal function, elevated blood glucose, and other adverse reactions(included hair loss, oliguria, acne, waist and knee weakness, etc.) in the combined group was significantly lower than the control group, and the difference was statistically significant. The combined group was significantly better than the control group in reducing the relapse rate, and the difference was statistically significant. Conclusion: The efficacy and safety of TCM medicine plus CTX on adult refractory nephrotic syndrome is better than Western medicine alone, but the exact efficacy still needs to be confirmed by prospective studies of higher quality.
出处
《中医临床研究》
2021年第16期136-144,共9页
Clinical Journal Of Chinese Medicine
基金
山西省科技攻关项目(2016ZD0307)
晋药综合开发利用协同创新中心项目(2017-JYXT-32)
山西省重点研发计划重点项目计划(201603D3113023)
山西省重点研发计划(指南)项目(201703D421024)
山西中医药大学研究生教育创新计划项目(2020JG001)。
关键词
中药
环磷酰胺
难治性肾病综合征
META分析
TCM medicine
Cyclophosphamide
Refractory nephrotic syndrome
Meta-analysis
作者简介
张李博,在读硕士研究生,研究方向为肾病。;通讯作者:刘光珍,教授,博士研究生导师。
