参芪地黄汤治疗气阴两虚型狼疮性肾炎临床疗效的Meta分析

Meta-analysis on the Clinical Effect of Shenqi Dihuang Decoction in the Treatment of Lupus Nephritis of Deficiency of Qi and Yin

目的系统评价参芪地黄汤加减在治疗气阴两虚型狼疮性肾炎的疗效及安全性。方法计算机检索中国知网、维普数据库、万方数据库、PubMed数据库及Springer电子期刊图书馆自建库以来有关参芪地黄汤治疗气阴两虚型狼疮性肾炎的文献,严格地按纳入和排除标准筛选文献并对数据资料进行提取,评价分析后,针对相关的结局指标采用RevMan 5.4.1软件进行Meta分析。结果最终纳入Meta分析的文献为9篇,共纳入682例狼疮性肾炎患者,其中治疗组纳入341例,对照组纳入341例。Meta分析结果显示,与对照组比较,中医药治疗狼疮性肾炎降低系统性红斑狼疮疾病活动度评分,降低中医证候积分,升高总有效率,降低不良反应,降低血肌酐,减轻24 h尿蛋白定量,降低血管内皮生长因子等方面差异有统计学意义,表明参芪地黄汤治疗气阴两虚型狼疮性肾炎疗效优于传统的西医治疗方案。结论此次Meta分析显示参芪地黄汤治疗气阴两虚型狼疮性肾炎在降低SLEDAI、降低中医证候积分、提高总有效率、降低不良反应、血肌酐、24 h尿蛋白及血管内皮生长因子方面疗效明显,差异具有统计学意义。

Objective To systematically evaluate the effect and safety of Shenqi Dihuang decoction and its addition in the treatment of lupus nephritis(LN)with deficiency of qi and yin.Methods The literatures about Shenqi Dihuang decoction in the treatment of LN with deficiency of qi and yin were searched from CNKI,VIP database,Wanfang database,Pub Med database and Springer electronic journal library.The literatures were screened strictly according to the inclusion and exclusion criteria and the data were extracted.After evaluation and analysis,Meta-analysis was performed on related outcome indicators using RevMan 5.4.1 software.Results A total of 9 literatures including 682 patients with lupus nephritis were included in the final meta-analysis,including 341 patients in the treatment group and 341patients in the control group.Meta-analysis results showed that compared with the control group,traditional Chinese medicine(TCM)treatment of LN reduced systemic lupus erythematosus(SLE)disease activity score,and reduced TCM syndrome score,increased the total effective rate,decreased the adverse reactions,decreased serum creatinine,decreased urinary protein level for 24 hours,There was statistical significance in the reduction of vascular endothelial growth factor,indicating that Shenqi Dihuang decoction had better efficacy than traditional western medicine in the treatment of LN with deficiency of both qi and yin.Conclusion This Meta analysis shows that Shenqi Dihuang decoction has significant efficacy in reducing SLEDAI,reducing TCM syndrome score,increasing total effective rate,reducing adverse reactions,serum creatinine,24 h urinary protein and vascular endothelial growth factor in the treatment of LN with deficiency of qi and yin,and the difference is statistically significant.