摘要
目的：用Meta分析方法评价中西医结合治疗中国成年人特发性膜性肾病（IMN）的疗效，为中西医结合治疗中国成年人IMN提供科学依据。方法：计算机检索PubMed、CBM、VIP、CNKI、万方等全文数据库，检索范围均从建库至2014年10月31日，筛选（1）中西医结合治疗组t（中药复方＋CTX＋Pred）治疗IMN的随机对照临床实验（RCT），（2）中西医结合治疗组2（中药复方＋ACEI和／或ARB）治疗IMN的RCT，用ReviewManager5．2（RevMan5．2）软件进行统计分析。结果：最终选出符合条件的12篇文献，包括698例IMN患者，其中试验组358例，对照组340例。Meta分析结果显示：（1）全部患者总体分析结果：①完全缓解率：中西医结合治疗组与单纯西药组相比，（OR=2．90，95％CI2．04～4．13），Z=5．94，P〈0．00001。②总有效率：（OR=3．61，95％CI2．47～5．30），Z=6．58，P〈0．00001。③不良反应率：（OR=0．26，95％C10．15～0．44），Z=4．90，P〈0．00001。（2）中西医结合治疗组1与CTX＋Pred相比，完全缓解率（OR=2．52，95％CI1．68—3．79），Z=4．46，P〈0．00001。总有效率（OR=4．13，95％CI2．53～6．74），Z=5．66，P〈0．00001。（3）中西医结合治疗组2与ACEI和／或ARB相比，完全缓解率（OR=4．33，95％CI2．12—8．82），Z=4．03，P〈0．0001。总有效率（OR=2．92，95％CI1．58—5．39）。Z=3．42，P=0．0006。结论：中西医结合疗法治疗IMN可提高临床疗效，改善预后。
Objective ：To assess the efficacy of combined traditional Chinese and Western medicine in treatment of idiopathic membranous nephropathy（IMN） by Meta- analysis, providing a scientific basis for combined traditional Chinese and Western medicine in treatment of idiopathic membranous nephropathy. Methods：The study searched Pubmed, CBM, CNKI, VIP and Wanfang databases, from the beginning of the databases to October 31 2014 for randomized controlled trials of IMN treatment （ 1 ） combined traditional Chinese and Western medicine VS CTX ＋ Pred ; （ 2 ） combined traditional Chinese and Western medicine VS ACEI or ARB. Review Manager 5.2 （ Revman 5.2） software was used to perform Meta - analysis. Results ： A total of 12 pieces of literature were enrolled, including 698 IMN patients （358 in study group, 340 in control group）. Meta- analysis on all patients ：（1）complete remission rate： combined traditional Chinese and Western Medicine VS Western medicine [ OR = 2.90,95 % CI （2.04 - 4.13 ）, Z = 5.94, P 〈 0.000 01 ] ; （2）total effect rate ： OR = 3.61,95 % CI （2.47 - 5.30）, Z = 6.58, P 〈 0. 000 01 ; （3）adverse reaction rate ： OR = 0.26,95 % CI 0.15 - 0.44 ）, Z = 4. 90,P 〈0.000 01. Combined traditional Chinese and Western medicine group VS CTX ＋ Pred：（1） complete remission rate ： OR = 2.52,95 % CI （ 1.68 - 3.79 ）, Z = 4.46, P 〈 0. 000 01 ; （2）total effect rate ： OR = 4.13,95 % CI （ 2.53 - 6.74 ）, Z =5.66,P 〈0. 000 01. Combined traditional Chinese and Western medicine VS ACEI or ARB：（1）complete remission rate：OR =4.33,95% CI 2.12 - 8.82 ,Z =4.03 ,P 〈0.000 1 ;（2）total effect rate：OR =2.92,95% CI（ 1.58 -5.39） ,Z = 3.42 ,P =0.000 6. Conclusions ：Available evidence showed combined traditional Chinese and western medicine in treat- ment of IMN for adults can get better clinical efficacy to improve prognosis compared with CTX ＋ Pred or ACEI or ARB.
出处
《中华中医药学刊》
CAS
北大核心
2015年第10期2496-2501,共6页
Chinese Archives of Traditional Chinese Medicine
关键词
特发性膜性肾病
中西医结合
META分析
完全缓解率
总有效率
idiopathic membranous nephropathy
combined traditional Chinese and western medicine
Meta - analysis
complete remission rate
total effective rate
