雷公藤多苷片联合激素治疗特发性膜性肾病的疗效和安全性的Meta分析

发布时间：2018-05-17 12:38

本文选题：雷公藤多苷片 + 激素　；参考：《北京中医药大学》2017年硕士论文

【摘要】：目的:用Meta分析方法评价雷公藤多苷片联合激素治疗特发性膜性肾病的疗效和安全性方法:检索Cochrane(建库至2016年7月),MEDLINE(建库至2016年7月),EMBASE OVID(建库至2016年7月),Pubmed(建库至2016年7月),CNKI(建库至2016年7月),万方(建库至2016年7月)、维普(建库至2016年7月)和SinoMed(建库至 2016 年)数据库,以 Tripterygium glycosides,Idiopathic membranous nephropathy,Nephrotic syndrome及相应中文作为关键词,对符合要求的随访研究进行资料提取和质量评价,并用Revman 5.3软件进行统计分析。结果:根据检索策略共检索到126篇,通过阅读文献标题和摘要进行初步筛选,必要时阅读全文,按纳入和排除标准最终纳入11篇研究(10篇RCT和1篇队列研究),共874例患者,其中治疗组(雷公藤多苷片+激素组)438例,对照组(其他药物组)436例。所有治疗组病例均使用糖皮质激素加雷公藤多苷片治疗。通过分析各组研究数据的总完全缓解率[RR=1.62(1.35,1.95),P0.00001]、总缓解率[RR=1.21(1.12,1.30),P0.0001],雷公藤多苷片加激素治疗3个月内的完全缓解率[RR=1.44(1.01,2.04),P=0.04]、总缓解率[RR=1.25(1.06,1.48),P=0.009],雷公藤多苷片加激素治疗治疗6个月的完全缓解率[RR=1.74(1.38,2.17),P0.00001]、总缓解率[RR=1.28(1.16,1.41),P0.00001]。通过Meta分析可知结果均有统计学意义,说明使用雷公藤多苷片联合激素的治疗组与对照组相比较,治疗后的完全缓解率及总缓解率存在差异,并表明雷公藤多苷片联合激素治疗特发性膜性肾病的治疗效果优于对照组。雷公藤多苷片作为免疫抑制剂的一种,在临床应用时也应注意其副作用。本研究统计的不良反应主要有肝功能异常、感染、白细胞下降、糖耐量异常等,根据本研究的结果,肝功能异常、胃肠道反应、闭经等副作用发生率相对较高,而且与对照组相比较,发生率无明显差异。结论:使用雷公藤多苷片联合激素治疗特发性膜性肾病的疗效好,副作用未见明显增加。
[Abstract]:Objective: to evaluate the efficacy and safety of Tripterygium wilfordii polyglycoside tablets combined with hormone in the treatment of idiopathic membranous nephropathy by Meta. By July 2016, CNKI (until July 2016), Wan Fang (until July 2016), Wip (until July 2016) and SinoMeddatabase (built to 2016), Taking Tripterygium glycosidesi idiopathic membranous pathogenetic syndrome and corresponding Chinese as keywords, data extraction and quality evaluation were carried out for the follow-up studies that meet the requirements, and statistical analysis was carried out with Revman 5.3 software. Results: according to the retrieval strategy, a total of 126 articles were retrieved, which were preliminarily screened by reading the titles and abstracts of the literature and, if necessary, the full text was read. According to the inclusion and exclusion criteria, 10 RCT and 1 cohort study were included in 11 studies and 1 cohort study. A total of 874 patients were included. There were 438 cases in the treatment group (Tripterygium wilfordii polyglycoside) group and 436 cases in the control group (other drugs group). All patients in the treatment group were treated with glucocorticoid plus tripterygium wilfordii polyglycoside tablets. By analyzing the total complete remission rate (RRN 1.62n 1.35U 1.95 P0.00001), the total remission rate (RRN 1.21) 1.121.30 P0.0001, the complete remission rate (RR1.441.012.04P0.04), the total remission rate (RRN 1.251.251.061.48P0. 009), the complete remission rate of tripterygium wilfordii tablet plus hormone treatment for 6 months, the complete remission rate of tripterygium wilfordii tablets and hormone treatment for 6 months. The decomposition rate [RRN 1.74 (1.38U) 2.17% P0.00001], the total remission rate [RRN 1.28 (1.161.41) (P0.00001)]. The results of Meta analysis showed that there were significant differences in the complete remission rate and the total remission rate between the treatment group and the control group after treatment with tripterygium wilfordii polyglycoside tablets combined with hormone. The therapeutic effect of tripterygium wilfordii polyglycosides combined with hormone on idiopathic membranous nephropathy was better than that of control group. Tripterygium wilfordii polyglycoside tablets as an immunosuppressant should also pay attention to its side effects in clinical application. According to the results of this study, the incidence of side effects such as abnormal liver function, gastrointestinal reaction, amenorrhea and other side effects is relatively high. Compared with the control group, there was no significant difference in the incidence rate. Conclusion: Tripterygium wilfordii polyglycoside tablet combined with hormone is effective in the treatment of idiopathic membranous nephropathy.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R692

【参考文献】