摘要
OBJECTIVE:To investigate the effectiveness and safety of tripterygium glycosides(TG)tablet(雷公藤多苷片)for the treatment of Lupus nephritis(LN).METHODS:Several databases were systematically searched including Pub Med,Embase,Cochrane,Wiley,China National Knowledge Infrastructure Database,Sino Med and Wanfang Library till June 20,2020.Revman5.3 was utilized to analyze the data according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement.RESULTS:In total,8 randomized controlled trials involving 583 participants were identified.Meta-analyses showed that,compared with glucocorticoids(GC)alone,the combination with TG tablet provided a statistically significant improvement in total remission(TR)(RR=1.27,95%CI:1.08–1.50,P=0.004),complete remission(CR)(RR=1.61,95%CI:1.05–2.47,P=0.03)and C3 levels(WMD=0.27,95%CI:0.14–0.39,P<0.0001),C4 levels(WMD=0.12,95%CI:0.07–0.17,P<0.00001).No significant differences were seen in TR,CR,proteinuria,serum creatinine,C3 and C4(TR:RR=1.00,95%CI:0.87–1.16,P=0.95;CR:RR=1.10,95%CI:0.78–1.56,P=0.58;proteinuria levels:WMD=-0.06,95%CI:-0.13 to 0.01,P=0.10;serum creatinine levels:WMD=-0.01,95%CI:-7.36 to 7.35,P=1.00;C3 levels:WMD=0.01,95%CI:-0.06 to 0.07,P=0.84;C4 levels:WMD=-0.01,95%CI:-0.03 to 0.01,P=0.49)between azathioprine(AZA)/leflomit(LEF)+GC and TG tablet+GC.Adverse events(hepatic dysfunction,nausea,vomitting)showed no statistical differences between the TG tablet+GC group and the GC group.There were more new onset of irregular menstruation in the TG tablet+GC group than those in the AZA+GC(RR=3.57,95%CI:1.40–9.11,P=0.008)/LEF+GC(RR=6.69,95%CI:2.42-18.46,P=0.0002)group,but leucopenia lower than those in AZA+GC group(RR=0.38,95%CI:0.17-0.85,P=0.02)and alopecia(RR=0.14,95%CI:0.03-0.77,P=0.02)and rash(RR=0.09,95%CI:0.01-0.69,P=0.02)lower than those in LEF+GC group.Conclusions:This review indicates that TG tablet maybe effective in LN treatment.Nevertheless,adverse events cannot be ignored.Large sample,multi-center,highquality clinical studies are needed to verify the exact effects and safety of TG tablet in treatment of LN.
基金
Supported by Department of Education of Guangdong Province:Study of Biomarkers Discovery for Patients with Relapsed Lupus Nephritis from the Perspective of Urinary Exosomal Microrna and Analysis of the Correlation with Pathogenic Dampness(2018KQNCX051)
Guangdong Provincial Hospital of Traditional Chinese Medicine:Study of Biomarkers Discovery for Patients with Relapsed Lupus Nephritis from the Perspective of Urinary Exosomal Microrna and Analysis of the Correlation with Pathogenic Dampness(YN2019QL19)
State Key Laboratory of Dampness Syndrome of Chinese Medicine:Early Warning and Intervention(SZ2021ZZ3204)。
