参芪地黄汤加减治疗狼疮性肾炎有效及安全性的系统评价

A Systematic Review of the Efficacy and Safety of Shenqi Dihuang Decoction in the Treatment of Lupus Nephritis

目的:系统评价参芪地黄汤加减治疗狼疮性肾炎的有效性及安全性。方法:检索PubMed、The Cochrane Library、Embase、Wed of Science、国家知识基础设施数据库、中国学术期刊数据库、中文科技期刊数据库等数据库,收集参芪地黄汤治疗狼疮性肾炎的随机对照试验(RCT),检索时间为建库至2020年7月。采用RevMan 5.3进行Meta分析。结果:最终纳入12项研究,共886例患者。Meta分析结果显示:观察组(参芪地黄汤联合西医常规治疗)在改善患者临床疗效,降低24 h尿蛋白定量,降低血管内皮生长因子(VEGF),降低系统红斑狼疮疾病活动指数(SLEDAI),提升补体C3含量等方面均优于对照组,差异有统计学意义(均P<0.05);观察组不良反应发生情况低于对照组,差异有统计学意义(P<0.05)。结论:参芪地黄汤加减治疗狼疮性肾炎疗效明确,且不良反应少,安全性好,值得临床推广应用。

Objective:To systematically review the efficacy and safety of Shenqi Dihuang Decoction in the treatment of lupus nephritis.Methods:PubMed,Cochrane Library,Embase,Wed of Science,CNKI,Wanfang Data,and VIP were searched to collect the randomized controlled trials(RCTs)on Shenqi Dihuang Decoction treating lupus nephritis from the establishment of the database to July 2020.RevMan 5.3 was used for Meta analysis.Results:Twelve studies were included,with a total of 886 patients.Meta-analysis showed that the experimental group(Shenqi Dihuang Decoction combined with conventional western medicine treatment)had enhanced clinical efficacy,and reduced 24 h urinary protein quantification,vascular endothelial growth factor(VEGF),and systemic lupus erythematosus disease activity index(SLEDAI),and increased content of complement C3,which were better than the conditions of the control group(P<0.05).In terms of safety,the occurrence of adverse reactions in the experimental group was lower than that of the control group(P<0.05).Conclusion:Shenqi Dihuang Decoction had a definite curative effect in the treatment of lupus nephritis,with few adverse reactions and high safety,which was worthy of clinical promotion.