益气活血法治疗特发性膜性肾病的Meta分析

发布时间：2018-01-03 05:07

本文关键词：益气活血法治疗特发性膜性肾病的Meta分析　出处：《中国中药杂志》2017年18期 　论文类型：期刊论文

【摘要】：特发性膜性肾病(IMN)的发病率越来越高,中医药治疗INM的临床研究也日益增多。该研究客观评价益气活血法治疗IMN的有效性和安全性。计算机检索了Pub Med,EMbase,the Cochrane Library,中国生物医学文献数据库(CBM),中国知网(CNKI),万方(Wanfang),维普(VIP)数据库。2名研究者单独筛选文献、提取资料,并用软件Rev Man 5.3作Meta分析,用软件GRADEprofiler 3.6按照GRADE系统对Meta分析的结局指标进行证据分级。最终纳入11个研究,共725例IMN患者。Meta分析结果显示:运用益气活血法治疗IMN,降低患者的24 h UTP[RR=-1.23,95%CI=(-1.94,-0.53),P=0.000 6],TC[RR=-0.39,95%CI=(-0.57,-0.20),P0.000 1]、TG[RR=-0.49,95%CI=(-0.82,-0.15),P=0.004]及升高ALB[RR=3.56,95%CI=(1.64,5.47),P=0.000 3]的效果显著优于对照组,且安全性[RR=0.23,95%CI=(0.10,0.52),P=0.000 4]更高。但在改善Scr[RR=-3.25,95%CI=(-9.35,2.84),P=0.30]和BUN[RR=-0.81,95%CI=(-2.29,0.66),P=0.28]方面无显著性差异。并统计临床使用频次居前6位的中药,依次是黄芪、当归、川芎、党参、白术、丹参。目前证据提示临床中治疗IMN时,当注重中医之益气活血法的应用,同时重视黄芪、当归、川芎等中药的合理使用;由于主要结局指标24 h UTP的GRADE证据等级为极低质量,尚缺乏高质量证据证实益气活血法的临床疗效,仍需要更多设计严瑾、大样本的多中心随机对照试验进一步加以验证。
[Abstract]:The incidence of idiopathic membranous nephropathy (IMN) is increasing. The clinical research of traditional Chinese medicine treating INM is increasing day by day. This study objectively evaluates the efficacy and safety of Yiqi Huoxue method in the treatment of IMN. The Pub Medembase was searched by computer. The Cochrane Library, China Biomedical Literature Database (CBM). The data were collected and analyzed by Meta software Rev Man 5.3. The results of Meta analysis were classified by software GRADEprofiler 3.6 according to GRADE system. Finally, 11 studies were carried out. The results of Meta-analysis of 725 patients with IMN showed that the method of invigorating qi and activating blood circulation was used to treat IMN, and the 24 h UTP of the patients was decreased. [RRU-1.23 / 95 / TC. [RRX -0.39% 95% CIQ -0.57U -0.20U P0.000 1] TG. [RRX -0.49 + 95% CIQ -0.82U -0.15U P0. 004] and elevated ALB. [The effect of RRN 3.56 ~ 95% CIQ 1.64 ~ 5.47 P0. 000 3 was significantly better than that of the control group, and the safety of RRN was better than that of the control group. [RRN 0.23 / 95 CIQ 0.10 / 0.52 / P0.0004] higher. But in improving Scr. [RRZ-3.25 / 95 CIQ -9.35 / 2.84 / P0. 30 and BUN. [There was no significant difference in RRX (-0.81) ~ (95) C ~ (-2.29) ~ (0.66) P ~ (0. 28). The most frequently used Chinese medicine in clinical use was Astragalus membranaceus and Angelica sinensis. Chuanxiong, Codonopsis, Atractylodes macrocephala, Salvia miltiorrhiza. The current evidence suggests that in the treatment of IMN, attention should be paid to the application of traditional Chinese medicine, such as Astragalus membranaceus, Angelica sinensis, Chuanxiong and so on. Because the main outcome indicator of 24 h UTP GRADE evidence grade is very low quality, the lack of high quality evidence to verify the clinical efficacy of Yiqi Huoxue method, there is still need for more design Yan Jin. Large-sample multicenter randomized controlled trials were further validated.
【作者单位】：北京中医药大学第一临床医学院;北京中医药大学东直门医院;
【分类号】：R277.5
【正文快照】： 特发性膜性肾病(idiopathic membranous ne-phropathy,IMN)为成人原发性肾病综合征最常见的原因[1],其病理特点是肾小球基底膜上皮细胞下免疫复合物沉积伴基底膜弥漫性增厚[2]。在我国,IMN的发病率约占所有肾小球疾病的10%,且正逐年上升[3]。由于该病约有20%~33%的自发缓解率,

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