益气活血法治疗局灶节段性肾小球硬化症的meta分析

Meta-analysis of Yiqi Huoxue Method in Treating Focal Segmental Glomerulosclerosis

目的:系统评价益气活血法治疗局灶节段性肾小球硬化症(FSGS)的有效性和安全性。方法:计算机检索了PubMed,EMbase,BMJ,中国期刊全文数据库(CNKI),万方全文数据库(Wanfang),维普中文科技期刊数据库(VIP)。2名研究者单独筛选文献、提取资料,并用软件RevMan5.3作Meta分析。结果:最终纳入10个研究,688名FSGS患者。Meta分析结果显示:和单纯西药组相比,以益气活血法配合西药治疗FSGS能显著降低24hUTP[SMD=-1.78,95%CI=(-2.62,-0.95),P<0.0001],Scr[MD=-18.35,95%CI=(-31.07,-5.63),P=0.005<0.05]和BUN[MD=-1.20,95%CI=(-1.97,-0.43),P=0.002<0.05]。在安全性方面,治疗组的不良反应明显低于对照组[OR=0.37,95%CI=(0.21,0.65),P=0.0005<0.05]。结论:当前证据显示,中药益气活血法为主配合西药治疗降低FSGS患者的24hUTP、Scr、BUN的疗效较对照组显著且安全性更高。临床治疗FSGS时,当重视中医益气活血法的应用。受纳入研究数量和质量限制,该结论尚需更多高质量、大样本、多中心的随机对照试验进一步验证。

Objective:To review the efficacy and safety of clinical studies on traditional Chinese medicine treatment of FSGS. Methods:Databases including PubMed,EMbase,BMJ,CNKI,Wang fang and VIP were searched.Two reviewers independently screened literature,extracted data,and then meta-analysis was performed.A total of 10 trials involving 688 patients were included. Results:Compared with the simple western medicine group,Yiqi Huoxue method could reduce 24 hUTP[ SMD =-1.78,95% CI -2.62 to -0.95, P <0.000 1],Scr [ MD =-18.35,95% CI -31.07 to -5.63, P =0.005<0.05]and BUN[ MD =-1.20,95% CI -1.97 to -0.43, P =0.002<0.05].In terms of the safety,the incidence of adverse reactions in the treatment group was lower than that in the control group[ OR =0.37,95% CI 0.21 to 0.65), P =0.000 5<0.05]. Conclusion:Yiqi Huoxue method has favourable therapeutic efficacy and safety,so the method should be taken seriously.Due to limited quantity and quality,the above conclusion should be verified again.