中药口服治疗肾纤维化随机对照试验的系统评价

Effectiveness of Taking TCM Orally in Renal Fibrosis: A Systematic of Randomized Controlled Trials

目的:系统评价中药口服治疗肾纤维化的临床疗效。方法:计算机检索The Cochrane library(2013年第10期)、Pub Med、EMbase、VIP、万方、CNKI、CBM中关于中药口服治疗慢性肾病肾纤维化的随机对照试验(RCT),检索时限均为从建库至2014年3月。由两名研究者按照纳入和排除标准独立进行文献筛选、资料提取、质量评价并交叉核对,采用RevMan 5.2软件进行meta分析。结果:最终纳入12个RCT,共828例患者。与对照组相比,在常规西药治疗的基础上加用中药口服,可明显降低Scr与BUN含量(P<0.05);并可降低血清PCⅢ、Ⅳ-C、LN、HA及尿CTGF、TGF-β1等肾纤维化指标(P<0.05),且现有研究无不良反应报道。结论:现有证据表明,在西医常规药物的基础上加用中药口服治疗慢性肾病肾纤维化,其效果明显优于单纯常规西药治疗。常用的口服中药为补益活血化瘀类。因纳入研究存在一定的方法学问题,上述结论尚需今后开展更高质量的相关研究加以验证。

Objective：To evaluate the effectiveness of taking Traditional Chinese medicine（ TCM）orally for renal fibrosis （ RF）. Methods：Such databases as the Cochrane library（ Issue 10,2013）,PubMed,EMbase,VIP,CNKI,CBM and WanFang Da-ta were searched from the inception to March,2014 to collect the randomized controlled trials（ RCTs）about taking TCM orally in treating RF. Two reviewers independently screened the literature according to the inclusion and exclusion criteria,extracted the data, and evaluated and cross-checked the methodological quality. Then meta-analysis was conducted using RevMan 5. 2 software. Re-sults：A total of 12 RCTs were included. Compared with the control group,the TCM group better promoted the recovery of renal func-tion by more reduction of Scr and BUN（P〈0. 05）. Taking TCM orally could treat renal fibrosis more effectively than control groups in PCⅢ,Ⅳ-C,LN,HA,CTGF and TGF-β1（P〈0. 05）. Conclusion：Combination of TCM with Western medicine therapies were more effective for renal fibrosis than Western medicine therapies only . It needs more multi-center,large samples and double blind RCTS. Furthermore standardized reports of the adverse reaction are needed.