【摘要】：目的系統(tǒng)評價雷公藤多苷聯(lián)合糖皮質(zhì)激素治療成年人原發(fā)性腎病綜合征(PNS)的有效性及安全性。方法計算機(jī)檢索中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(CBM)、中國知網(wǎng)(CNKI)、維普網(wǎng)、萬方數(shù)據(jù)知識服務(wù)平臺、Cochrane Library、Pub Med、科學(xué)引文索引(SCI)數(shù)據(jù)庫,手工檢索有關(guān)中醫(yī)、中西醫(yī)結(jié)合和腎臟疾病相關(guān)雜志,檢索時間為建庫/創(chuàng)刊至2016年3月。納入試驗(yàn)組干預(yù)措施為雷公藤多苷聯(lián)合糖皮質(zhì)激素,對照組單用足量糖皮質(zhì)激素的隨機(jī)對照試驗(yàn)。使用Stata 12.0軟件對總緩解率、不良反應(yīng)發(fā)生率進(jìn)行Meta分析。結(jié)果共納入18篇文獻(xiàn),包括1 236例患者,其中對照組620例,試驗(yàn)組616例。Meta分析結(jié)果顯示,試驗(yàn)組總緩解率高于對照組[RR=1.21,95%CI(1.11,1.32),P0.001]。亞組分析結(jié)果顯示,雷公藤多苷聯(lián)合中等劑量糖皮質(zhì)激素總緩解率高于對照組[RR=1.11,95%CI(1.02,1.20),P=0.015];雷公藤多苷聯(lián)合足量糖皮質(zhì)激素總緩解率高于對照組[RR=1.31,95%CI(1.22,1.41),P0.001]。試驗(yàn)組不良反應(yīng)發(fā)生率低于對照組[RR=0.51,95%CI(0.37,0.70),P0.001]�？偩徑饴事┒穲D不對稱,提示存在發(fā)表偏倚。結(jié)論雷公藤多苷聯(lián)合糖皮質(zhì)激素較單純使用糖皮質(zhì)激素治療PNS可提高總緩解率,減少不良反應(yīng)發(fā)生率,有望成為一種有前景的治療方案,但納入文獻(xiàn)的方法學(xué)質(zhì)量不高,需更多高質(zhì)量研究進(jìn)一步證實(shí)。
[Abstract]:Objective to evaluate the efficacy and safety of Tripterygium wilfordii polyglycosides combined with glucocorticoid in the treatment of adult primary nephrotic syndrome (PNS). Methods the Chinese biomedical literature database (CBM), China knowledge network (CNKI), Wanfang data knowledge service platform, Cochrane Library,Pub Med, scientific citation index (SCI) database were searched by computer, and related traditional Chinese medicine was searched manually. Integrated traditional Chinese and western medicine and kidney disease related journals, retrieval time for database / launch until March 2016. The intervention measures of the experimental group were Tripterygium wilfordii polyglycosides combined with glucocorticoids, and the control group was treated with enough glucocorticoids alone. The total remission rate and the incidence of adverse reactions were analyzed by Meta with Stata 12.0 software. Results A total of 18 articles were included, including 1 236 patients, including 620 patients in the control group and 616 patients in the test group. Meta-analysis showed that the total remission rate in the test group was higher than that in the control group [RR=1.21,95%CI (1.11, 1.32), P0.001]. The results of subgroup analysis showed that the total remission rate of Tripterygium wilfordii polyglycosides combined with medium dose glucocorticoid was higher than that of the control group [RR=1.11,95%CI (1.02, 1.20), P 鈮，

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