雷公藤多苷联合糖皮质激素治疗成年人原发性肾病综合征效果的Meta分析

发布时间：2019-06-05 05:05

【摘要】：目的系统评价雷公藤多苷联合糖皮质激素治疗成年人原发性肾病综合征(PNS)的有效性及安全性。方法计算机检索中国生物医学文献数据库(CBM)、中国知网(CNKI)、维普网、万方数据知识服务平台、Cochrane Library、Pub Med、科学引文索引(SCI)数据库,手工检索有关中医、中西医结合和肾脏疾病相关杂志,检索时间为建库/创刊至2016年3月。纳入试验组干预措施为雷公藤多苷联合糖皮质激素,对照组单用足量糖皮质激素的随机对照试验。使用Stata 12.0软件对总缓解率、不良反应发生率进行Meta分析。结果共纳入18篇文献,包括1 236例患者,其中对照组620例,试验组616例。Meta分析结果显示,试验组总缓解率高于对照组[RR=1.21,95%CI(1.11,1.32),P0.001]。亚组分析结果显示,雷公藤多苷联合中等剂量糖皮质激素总缓解率高于对照组[RR=1.11,95%CI(1.02,1.20),P=0.015];雷公藤多苷联合足量糖皮质激素总缓解率高于对照组[RR=1.31,95%CI(1.22,1.41),P0.001]。试验组不良反应发生率低于对照组[RR=0.51,95%CI(0.37,0.70),P0.001]。总缓解率漏斗图不对称,提示存在发表偏倚。结论雷公藤多苷联合糖皮质激素较单纯使用糖皮质激素治疗PNS可提高总缓解率,减少不良反应发生率,有望成为一种有前景的治疗方案,但纳入文献的方法学质量不高,需更多高质量研究进一步证实。
[Abstract]:Objective to evaluate the efficacy and safety of Tripterygium wilfordii polyglycosides combined with glucocorticoid in the treatment of adult primary nephrotic syndrome (PNS). Methods the Chinese biomedical literature database (CBM), China knowledge network (CNKI), Wanfang data knowledge service platform, Cochrane Library,Pub Med, scientific citation index (SCI) database were searched by computer, and related traditional Chinese medicine was searched manually. Integrated traditional Chinese and western medicine and kidney disease related journals, retrieval time for database / launch until March 2016. The intervention measures of the experimental group were Tripterygium wilfordii polyglycosides combined with glucocorticoids, and the control group was treated with enough glucocorticoids alone. The total remission rate and the incidence of adverse reactions were analyzed by Meta with Stata 12.0 software. Results A total of 18 articles were included, including 1 236 patients, including 620 patients in the control group and 616 patients in the test group. Meta-analysis showed that the total remission rate in the test group was higher than that in the control group [RR=1.21,95%CI (1.11, 1.32), P0.001]. The results of subgroup analysis showed that the total remission rate of Tripterygium wilfordii polyglycosides combined with medium dose glucocorticoid was higher than that of the control group [RR=1.11,95%CI (1.02, 1.20), P 鈮，

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