摘要
目的评价雷公藤多苷(TG)联合环磷酰胺(CTX)+糖皮质激素治疗肾病综合征(NS)的疗效和安全性。方法分别以雷公藤多苷、环磷酰胺、肾病综合征的中英文标准词汇为检索词在知网、万方、维普和中国生物医学文献数据库,以及Pubmed、Embase、web of science和Science Direct共8个中英文数据库进行检索。文献起止时间均从建库至2020年8月31日。2位研究者独立检索并筛选雷公藤多苷联合环磷酰胺、糖皮质激素治疗NS的临床随机对照试验(RCT),采用Revman5.4软件对提取出的数据进行Meta分析。结果筛选出7篇中文RCT研究,共518例NS患者,其中治疗组259例,对照组259例。Meta分析结果显示,治疗组总有效率[OR=3.83,95%CI(2.27,6.46),P<0.00001]明显高于对照组,治疗组24h尿蛋白定量[MD=-1.68,95%CI(-1.94,-1.41),P<0.00001]优于对照组。治疗组白细胞减少[RR=0.44,95%CI(0.20,0.98),P=0.04]的相对风险低于对照组,然而两组在胃肠道反应和肝损害中无统计学意义。结论雷公藤多苷联合环磷酰胺+糖皮质激素治疗NS较单纯西药治疗疗效显著,在一定程度上可减少不良反应的发生,但仍需要更多高质量RCT予以证实。
Objective To evaluate the efficacy and safety of Tripterygium glycosides(TG) combined with cyclophosphamide(CTX) plus glucocorticoid in the treatment of nephrotic syndrome(NS).Methods retrieval strategy combined with tripterygium glycosides, cyclophosphamide and nephrotic syndrome were used to retrieve articles published in 8 databases(including China National Knowledge Infrastructure(CNKI),Wanfang, Weipu and China Biomedical Literature Database, Pubmed, Embase, web of Science and Science Direct databases)before August 31,2020.Two researchers independently searched and screened the retrieved literatures, and the third senior researcher would give the final decision when dissidencing.The Reviewer Manager 5.4 software was used to analyze the data.Results A total of 518 patients with NS were selected from 7 RCT studies, including 259 in the treatment group and the control group, separately.The results of Meta analysis showed that the total effective rate[OR=3.83,95%CI(2.27,6.46),P<0.00001] in the treatment group was significantly higher than that in the control group, and the 24 h urinary protein quantification[MD=-1.68,95% CI(-1.94,-1.41),P<0.00001] in the treatment group was superior to that in the control group.Therelative risk[RR=0.44,95% CI(0.20,0.98),P=0.04] in the treatment group was lower than that in the control group, however, there was no significant difference between the two groups in gastrointestinal side effects and liver damnification.Conclusion Tripterygium Wilfordii polyglycoside combined with cyclophosphamide plus Glucocorticoid is more effective and less adverse reactions than the latter both alone in treating NS,but still need more high-quality RCT to confirm.
作者
孔维健
孙昊琦
郭振涛
王向明
KONG Weijian;SUN Haoqi;GUO Zhentao;WANG Xiangming(Department of Internal Medicine,Weifang Medical University,Weifang 261053,China;Department of Nephrology,the Affiliated Hospital of Weifang Medical University)
出处
《潍坊医学院学报》
2021年第1期73-75,共3页
Acta Academiae Medicinae Weifang
