中医药治疗IgA肾病随机对照试验的系统评价

The Systematic Review on Randomized Controlled Trials of Traditional Chinese Medicine Treatment for IgA Nephropathy

目的:评价中医药治疗IgA肾病的疗效和安全性。方法:参照Cochrane系统评价的要求,应用Revman5.0.15Meta分析软件对选择纳入的临床试验进行方法学质量评价、数据提取和分析。结果:12篇包括1104例患者的随机或半随机对照试验纳入并进行系统评价。根据Jadad方法学评分,所纳入的试验质量普遍较低,仅有2个研究评分高于3分,属于高质量试验。Meta-分析结果表明,中医药治疗IgA肾病在临床综合疗效、减少中小量蛋白尿、降低血浆IgA水平、控制Scr这几方面优于西医治疗;未报告严重的不良反应。对尿红细胞的疗效,因计量单位差异导致纳入研究不足,致使疗效难以肯定,需在今后的研究中进一步证实。结论:中医药在临床综合疗效、减少中小量蛋白尿、稳定肾功能方面有较好的疗效,表明中医药治疗IgA肾病是一种有前景的选择,值得深入探索。对尿红细胞的疗效,因计量单位差异导致纳入研究不足,致使疗效难以肯定,需在今后的研究中进一步证实。由于所纳入试验的方法学质量普遍较低,上述发现需要设计严谨的、方法学质量较高的随机对照试验的证据支持。

Objective： To evaluate efficacy and safety of Traditional Chinese Medicine（ TCM） Treatment for IgA nephropathy.Methods： According to the Cochrane reviewer′s handbook,we make a series of methodological quality assessment、data extraction and analysis to included clinical trials by Revman 5.0.15 Meta analysis software.Results： 12 studys（ 1104 patients） were included for the systematic review.According to Jadad score,included trials were generally low quality,only two studies score higher than 3 points,belong to high-quality trials.Meta-analysis showed that TCM treatment for IgA nephropathy is better than western medicine treatment in the clinical efficacy,reducing proteinuria,lowering levels of plasma IgA and controlling Scr.The efficacy of urine red blood cells is uncertain because of different measurement units and has to be confirmed in future studies.Conclusion： TCM treatment for IgA nephropathy has a good effect in the clinical efficacy,reducing proteinuria,stabling renal function.And it indicates that TCM treatment IgA nephropathy is a promising option.The efficacy of urine red blood cells is uncertain because of different measurement units and has to be confirmed in future studies.Since the methodological quality of included trials is generally low,above conclusions need to be supported by those randomized controlled trials which is rigorous-designed and high methodological quality.