Clinical Effect of Tripterygium Glycosides Combined with Glucocorticoids in the Treatment of Refractory Nephrotic Syndrome Patients: A Systematic Review and Meta-Analysis

The objective of this study is to evaluate the effectiveness and safety of Tripterygium glycosides combined with glucocorticoids for the treatment of refractory nephrotic syndrome(NS).Computer search of Chinese and English databases,including CNKI,VIP,Wan Fang Database,PubMed,Cochrane Library,Embase,and Sinomed,for randomized controlled trials(RCTs)of Tripterygium glycosides combined with glucocorticoids for refractory NS(RNS)was conducted.Meta-analysis was performed using RevMan5.3.Thirteen RCTs comprising 994 patients were included in the study.Tripterygium glycosides combined with glucocorticoids had a statistical significance on the effective rate(odds ratio[OR]=4.69,95%confidence interval[CI]3.29,6.67,P<0.00001),24-h urine protein(Weighted mean difference(MD)=-0.57,95%CI[-0.62,-0.51],P<0.00001),serum albumin(MD=4.77,95%CI[4.30,5.24],P<0.00001),total serum protein(MD=9.45,95%CI[8.73,10.17],P<0.00001),urea nitrogen(MD=-0.53,95%CI[-0.90,-0.17],P=0.005),and serum creatinine(MD=-8.45,95%CI[-15.32,-1.57],P=0.02).There was no statistical significance on adverse reactions(OR=0.68,95%CI[0.41,1.12],P=0.13).Tripterygium glycosides combined with glucocorticoids could improve clinical effective rate,reduce 24-h urine protein,improve serum albumin and total serum protein,and reduce urea nitrogen and serum creatinine levels in patients with RNS.However,the quality of the included literature is poor,and conclusion still needs further verification using larger samples and high-quality randomized,double-blind controlled trials.

Meta-Analysis of Niaoduqing Granules Combined With RAAS System Blocker in the Treatment of Diabetic Nephropathy

To systematically evaluate the efficacy of urinary granules combined with RAAS system blockers in the treatment of diabetic nephropathy(DN).A meta-analysis of the data required in the literature in accordance with this study was performed using Rev Man 5.3 software.Fifteen randomized controlled trials were analyzed in the present study to evaluate the clinical effect of Niaoduqing-angiotensin converting enzyme inhibitors/angiotensin receptor blocker(ACEI/ARB)in DN patients.A total of 1063 patients were involved,including 538 patients receiving the combination treatment and 525 patients in the control group.The results showed that the clinical efficacy of Niaoduqing granule combined with ACEI/ARB was significantly better than of the control group(odds ratio=2.92,95%confidence interval[CI]1.76–4.86).The treatment combined with Niaoduqing granule decreased the 24-h urinary protein quantitation(mean difference[MD]0.71,95%CI 0.28–1.14)and urine albumin excretion rate(UAER)(MD 41.13,95%CI 26.66–55.59)levels.However,the combination group had no treatment advantage on reducing serumurea nitrogen(MD 0.86,95%CI 0.05–1.68,P=0.02)and fasting blood glucose(MD-0.03,95%CI-0.15–0.09,P=0.61).And there was no significance in adverse events between two groups(risk ratio=2.34,95%CI 0.69–7.95,P=0.17).Niaoduqing granule-ACEI/ARB combination group maybe as safe as ACEI/ARB alone,and the combination played an advantage in improvement in total effective rate,reduction of 24-h urinary protein quantitation and UAER.