肾炎康复片联合激素治疗肾病综合征有效性Meta分析

Effectiveness of nephritis rehabilitation tablets combined with glucocorticoid for nephrotic syndrome:a Metaanalysis

目的通过Meta分析比较肾炎康复片联合激素等西医常规疗法治疗肾病综合征(NS)的有效性。方法系统检索Pub Med、The Cochrane Library(2015年第12期)、Embase、CNKI、CBM、VIP、Wan-Fang数据库中相关临床随机对照试验(RCT),检索时限为各数据库建库至2015年12月23日。两名研究者独立地进行文献筛选、数据提取及文献质量评价。运用Rev Man5.3软件进行统计分析。结果共纳入10个RCT,合计NS患者755例。Meta分析结果显示,肾炎康复片联合激素等西医常规疗法与单一西医疗法在治疗有效率、减少24 h尿蛋白、增加血浆白蛋、降低胆固醇和三酰甘油等方面疗效差异有统计学意义,在降低血肌酐、尿素氮方面疗效差异无统计学意义。敏感性分析结果未发生明变化,漏斗图显示本研究无明显发表偏倚。结论肾炎康复片联合激素等西医常规法治疗肾病综合征疗效明显优于单一西医疗法,值得临床推广。

Objective To evaluate the effectiveness of nephritis rehabilitation tablets combined with glucocorticoid （routine westem treatment） in the treatment ofnephrotic syndrome. Methods We systematically searched the PubMed, Cochrane Library （Issue 12, 2015）, Embase, CNKI, CBM, VIE and Wan-Fang databases for relevant clinical randomized controlled trials （RCT） dated up to December 23, 2015. Two reviewers independently selected the studies, extracted information, and assessed quality. Statistical analysis was made by using KevMan 5.3 software. Results Ten RCTs with 755 patients were included. The pooled results showed that compared with western medicine alone, nephritis rehabilitation tablets combined with routine western medicine could significantly improve the treatment effiiency, decrease the urinary protein, increase the plasma albumin, reduce the level of triglyceride and total cholesterol, and the difference was statistical. But there were no differences in decreasing the serum creatinine and blood urea nitrogen. The sensitivity analysis results were not significantly altered, and funnel plots showed there were no obviously publication bias in our study. Conclusion Current evidence suggests that nephritis rehabilitation tablets combined with glucocorticoid is superior to western medicine alone in the treatment of nephrotic sydrome, and it is worth spreading in clinical practice.