中西医结合治疗原发性尿酸性肾病疗效的Meta分析

Meta-analysis of the curative Effect of integrated traditional Chinese and western medicine therapy on primary uric acid nephropathy

目的评价中西医结合治疗原发性尿酸性肾病的临床疗效及安全性。方法全面检索维普数据库(1989—2011年)、万方数据库(1989—2011年)、中国知识期刊网(1989—2011年)、MEDLINE(1989—2011年),收集中西医结合治疗原发性尿酸性肾病的随机对照试验。采用RevMan5.0.1软件进行统计分析,采用优势比(比值比)作为效应合并指标。结果符合纳入标准的随机对照试验有22项,共1 500例患者。所有试验质量普遍不够高,未发现双盲试验。Meta分析结果显示,中西医结合治疗与单用西药治疗原发性尿酸性肾病相比,其对总有效率、显效率、有效率的影响差异有统计学意义。用Stata软件进行Begg秩相关检验和Egger线性回归法检测漏斗图基本对称,说明无明显发表性偏倚。结论 Meta分析提示中西医结合疗法较单用西药治疗原发性尿酸性肾病更为有效,但所纳入研究的随机对照试验质量尚不够高,最终结论还有待进一步探讨。

Objective It is to evaluate the clinical curative effect and its safety of integrated traditional Chinese and west- ern medicine therapy on primary uric acid nephropathy. Methods All the randomized controlled trials （RCTs） of integrated traditional Chinese and western medicine therapy for primary uric acid nephropathy from VIP database, WanFang database, CNKI and MEDLINE（1989--2011） were searched. RevMan 5. O. 1 was used in the statistical analysis. Meta-analysis was conducted combining the odd radios of the individual studies. Results 22 RCTs involving 1 500 patients met the inclusion cri- teria. All of the trials were not adequate enough in methodological quality. None of them was double-blind trial. The result of Meta-analysis indicated that compared with the treatment with western medicine only, integrated traditional Chinese and west- ern medicine therapy could raise the total clinical effective rate, the obvious effective rate and the effective rate. The funnel plot detected by Begg＇ s rank correlation test and Egger＇ s linear regression method was basic symmetrical using Stata software. It suggested that no obvious publication bias had been found. Conclusion The clinical evidence derived from the analysis sug- gests that integrated traditional Chinese and western medicine therapy is more effective than basic western medicine therapy for primary uric acid nephropathy, hut a final conclusion needs further exploration due to the lower quality of RCTs.