Objective:To systemically review the efficacy and safety about the method of enriching qi,activating blood circulation,clearing away dampness and heat combined with western medicine in the therapy of patients with idi...Objective:To systemically review the efficacy and safety about the method of enriching qi,activating blood circulation,clearing away dampness and heat combined with western medicine in the therapy of patients with idiopathy membranous nephropathy(IMN).Methods:We collected the randomized controlled trials(RCTs)of enriching qi,activating blood circulation,clearing away dampness and heat for the treatment of IMN from Pub Med,The Cochrane Library,Medline,China National Knowledge Infrastructure(CNKI),China Biology Medicine disc(CBM),Wanfang Data and Wiper Databases.Bias of risk of retrieval literature was evaluated according to Cochrane Collaboration standard,and Review Manager 5.3 software was used for statistical analysis.Results:Fourteen trials(836 participants)were included in the meta-analysis.This kind of traditional Chinese method combined with western medicine in the treatment of IMN exerted statistical differences in reducing 24-hour urinary protein[WMD=-0.97,95%CI(-1.30,-0.65),Z=5.86(P<0.00001)]and elevating serum albumin[WMD=3.83,95%CI(2.10,5.57),Z=4.33,P<0.0001],lowering serum cholesterol[WMD=-0.82,95%CI(-1.08,-0.56),Z=6.18,P<0.00001],triglycerides[WMD=-0.39,95%CI(-0.67,-0.11),Z=2.77,P=0.006]and reducing the risk of adverse events[OR=0.29,95%CI[0.16,0.50],Z=4.35,P<0.0001]in the patients with IMN as compared with controls.However,there was no statistically significant difference between the method and controls when combining all trials in serum creatinine[WMD=-5.52,95%CI(-18.06,7.03),Z=0.86,P=0.39],when combining all trials in urea nitrogen[WMD=-0.90,95%CI(-2.22,0.41),Z=1.35,P=0.18].Conclusion:The method of enriching qi,activating blood circulation,clearing away dampness and heat combined with western medicine exerts certain advantages and better safety in treating patients with IMN.However,for the inferiority of the included studies,the conclusion still needs high-quality and large-sample prospective randomized controlled trials to verify.展开更多
Objective:The objective of this study was to systematically evaluate the clinical efficacy of the integration method of heat-clearing, dampness-excreting,spleen-strengthening, and stasis-removing from traditional Chin...Objective:The objective of this study was to systematically evaluate the clinical efficacy of the integration method of heat-clearing, dampness-excreting,spleen-strengthening, and stasis-removing from traditional Chinese medicine (TCM) combined with Western medicine for the treatment of ulcerative colitis(UC).Materials and Methods:The databases China National Knowledge Infrastructure,China Biology Medicinedisc(CBMdisc),WANFANG, VIP, and PubMed were searched for randomized controlled trials investigating the integration of the TCM methods of clearing heat,draining dampness, invigorating the spleen, and removing stasis, combined with Western medicine to treat UC from January 2009 to March 2019. Two reviewers independently conducted literature searches, screenings, data extractions, and literature bias evaluations. A meta-analysis was conducted using RevMan 5.3 and Stata 13.0 software. Results:In total, 15 studies involving 1289 patients were included. The results of the meta-analysis showed that the total effective rate of treatment in the experimental groups was higher than that of the control groups (relative risk [RR]=1.27, 95%confidence interval [CI]:1.21, 1.35, Z=8.74, P <0.00001). In the subgroup analysis, the total effective rate of oral TCM combined with Western medicine was higher than that of the control groups (RR=1.24, 95%CI:1.15, 1.33, Z=5.88, P <0.00001). The total effective rate of oral TCM with enemas combined with Western medicine was higher than that of the control group (RR=1.30, 95%CI:1.12, 1.50, Z=3.52, P=0.0004).The comparison between Western medicine alone and oral TCM combined with enteroscopy and Western medicine showed that the effective rate of enteroscopy (RR=1.18, 95%CI:1.05, 1.33, Z=2.86, P=0.004) and the symptom scores before and after treatment all improved more in the combined treatment groups than in those of the Western medicine group alone, with statistically significant differences (RR=-4.23, 95%CI:-4.93,-3.53, Z=11.84, P <0.00001). Conclusion:The integration of the TCM methods of heat clearing, dampness excreting, spleen strengthening, and stasis removing combined with Western medicine can significantly improve the cure rate of UC, and is an effective method to treat UC.展开更多
基金Scientific Research Special Project of Capital Health Development in 2018(No.First issues 2018-1-4192)TCM Science and Technology Development Fund of Beijing in 2020(No.JJ-2020-42)。
文摘Objective:To systemically review the efficacy and safety about the method of enriching qi,activating blood circulation,clearing away dampness and heat combined with western medicine in the therapy of patients with idiopathy membranous nephropathy(IMN).Methods:We collected the randomized controlled trials(RCTs)of enriching qi,activating blood circulation,clearing away dampness and heat for the treatment of IMN from Pub Med,The Cochrane Library,Medline,China National Knowledge Infrastructure(CNKI),China Biology Medicine disc(CBM),Wanfang Data and Wiper Databases.Bias of risk of retrieval literature was evaluated according to Cochrane Collaboration standard,and Review Manager 5.3 software was used for statistical analysis.Results:Fourteen trials(836 participants)were included in the meta-analysis.This kind of traditional Chinese method combined with western medicine in the treatment of IMN exerted statistical differences in reducing 24-hour urinary protein[WMD=-0.97,95%CI(-1.30,-0.65),Z=5.86(P<0.00001)]and elevating serum albumin[WMD=3.83,95%CI(2.10,5.57),Z=4.33,P<0.0001],lowering serum cholesterol[WMD=-0.82,95%CI(-1.08,-0.56),Z=6.18,P<0.00001],triglycerides[WMD=-0.39,95%CI(-0.67,-0.11),Z=2.77,P=0.006]and reducing the risk of adverse events[OR=0.29,95%CI[0.16,0.50],Z=4.35,P<0.0001]in the patients with IMN as compared with controls.However,there was no statistically significant difference between the method and controls when combining all trials in serum creatinine[WMD=-5.52,95%CI(-18.06,7.03),Z=0.86,P=0.39],when combining all trials in urea nitrogen[WMD=-0.90,95%CI(-2.22,0.41),Z=1.35,P=0.18].Conclusion:The method of enriching qi,activating blood circulation,clearing away dampness and heat combined with western medicine exerts certain advantages and better safety in treating patients with IMN.However,for the inferiority of the included studies,the conclusion still needs high-quality and large-sample prospective randomized controlled trials to verify.
基金financially supported by Project of China-Japanese Friendship Hospital,the study on the pathogenesis of UC with syndrome of retention of dampness heat in large intestine based on relevant pathways of “bacteria–intestine–brain axis”(2019-JYB-JS-020)。
文摘Objective:The objective of this study was to systematically evaluate the clinical efficacy of the integration method of heat-clearing, dampness-excreting,spleen-strengthening, and stasis-removing from traditional Chinese medicine (TCM) combined with Western medicine for the treatment of ulcerative colitis(UC).Materials and Methods:The databases China National Knowledge Infrastructure,China Biology Medicinedisc(CBMdisc),WANFANG, VIP, and PubMed were searched for randomized controlled trials investigating the integration of the TCM methods of clearing heat,draining dampness, invigorating the spleen, and removing stasis, combined with Western medicine to treat UC from January 2009 to March 2019. Two reviewers independently conducted literature searches, screenings, data extractions, and literature bias evaluations. A meta-analysis was conducted using RevMan 5.3 and Stata 13.0 software. Results:In total, 15 studies involving 1289 patients were included. The results of the meta-analysis showed that the total effective rate of treatment in the experimental groups was higher than that of the control groups (relative risk [RR]=1.27, 95%confidence interval [CI]:1.21, 1.35, Z=8.74, P <0.00001). In the subgroup analysis, the total effective rate of oral TCM combined with Western medicine was higher than that of the control groups (RR=1.24, 95%CI:1.15, 1.33, Z=5.88, P <0.00001). The total effective rate of oral TCM with enemas combined with Western medicine was higher than that of the control group (RR=1.30, 95%CI:1.12, 1.50, Z=3.52, P=0.0004).The comparison between Western medicine alone and oral TCM combined with enteroscopy and Western medicine showed that the effective rate of enteroscopy (RR=1.18, 95%CI:1.05, 1.33, Z=2.86, P=0.004) and the symptom scores before and after treatment all improved more in the combined treatment groups than in those of the Western medicine group alone, with statistically significant differences (RR=-4.23, 95%CI:-4.93,-3.53, Z=11.84, P <0.00001). Conclusion:The integration of the TCM methods of heat clearing, dampness excreting, spleen strengthening, and stasis removing combined with Western medicine can significantly improve the cure rate of UC, and is an effective method to treat UC.
