摘要
目的:为系统评价中药复方联合RAS抑制剂治疗IgA肾病的临床疗效。方法:通过计算机全面检索中国知网、维普、万方医学网、中国生物医学文献服务系统、PubMed、web of science数据库建库至2020年9月公开发表的有关中药复方+RAS抑制剂治疗IgA肾病的临床研究,删除重复文献,通过阅读题目、摘要及全文,剔除与纳入排除标准不符合的文献,对筛选后的文献进行数据提取,采用Cochrane偏倚风险评价工具对纳入文章进行质量评估,利用Review Manager5.3软件对文章进行Meta分析。结果:最终纳入文献15篇,Meta分析结果显示:中药复方联合RAS抑制剂治疗IgA肾病可提高临床有效率(OR=3.12,95%CI[2.30,4.25],P<0.00001);减少24h尿蛋白定量(MD=-0.27,95%CI[-0.34,-0.19],P<0.00001);降低尿红细胞数量(SMD=-1.35,95%CI[-1.95,-0.76],P<0.00001);延缓肾功能Scr水平(MD=-7.13,95%CI[-8.46,-5.80],P<0.00001)和Bun水平(MD=-0.57,95%CI[-0.65,-0.49],P<0.00001)。结论:中药复方联合RAS抑制剂治疗IgA肾病比单纯西医基础治疗有一定的优势,能够有效改善临床症状和实验室指标,但是由于纳入文献较少,文章质量参差不齐,该结论需要大量多样本、多中心、高质量的临床随机对照实验进行验证。
Objective: To systematically evaluate the clinical efficacy of TCM compound combined with RAS inhibitor in the treatment of Ig A nephropathy. Methods:Computer retrieval hownet, VIP, ten thousand China side medical network, service system of Chinese biomedical literature database,PubMed,webofscience built libraries to be published on September,2020 on Chinese traditional medicine compound+RAS inhibitors for the treatment of Ig A nephropathy clinical research,remove duplicate documents,by reading the title,abstract and full text out and into the exclusion criteria do not conform to the literature,the data of the literature of screening after extraction,the use of the Cochrane bias risk assessment tools for quality assessment included in the article,ReviewManager5.3 software was used for meta-analysis of the article. Results:Fifteen literatures were included.Meta-analysis results showed that TCM compound combined with RAS inhibitor in the treatment of Ig A nephropathy could improve the clinical response rate(OR=3.12, 95%CI[2.30, 4.25],P<0.00001).24 h urinary protein level was reduced(MD=-0.27, 95%CI[-0.34,-0.19], P<0.00001);Decreased the number of urinary RBC(SMD=-1.35, 95%CI[-1.95,-0.76],P< 0.00001);Delayed renal function SCR(Md =-7.13, 95%CI[-8.46,-5.80],P<0.00001) and BUN(Md =-0.57, 95%CI[-0.65,-0.49],P <0.00001). Conclusion:Chinese medicine compound joint RAS inhibitors in the treatment of Ig A nephropathy than pure western medicine foundation treatment has certain advantages,can effectively improve the clinical symptoms and laboratory indexes, but with less into literature,the paper quality is uneven, the conclusion will need a lot of variety,multicenter,high quality validated clinical randomized controlled trials.
作者
崔锦涛
陈幸萌
金劲松
CUI Jin-tao;CHEN Xing-meng;JIN Jin-song(The Clinical College of Chinese Medicine,Hubei University of Chinese Medicine,Wuhan,430060;Renal Division,Department of Medicine,Hubei Provincial Hospital of Traditional Chinese Medicine,Wuhan,430060)
出处
《农垦医学》
2021年第2期97-102,117,共7页
Journal of Nongken Medicine
关键词
IGA肾病
中西医结合治疗
RAS抑制剂
META分析
IgA nephropathy
Integrated traditional Chinese and western medicine treatment
RAS inhibitors
Meta analysis
