【摘要】：目的 通過(guò)翻閱文獻(xiàn),用循證醫(yī)學(xué)的方法,評(píng)價(jià)中西醫(yī)結(jié)合治療小兒原發(fā)性腎病綜合征的療效,為中西醫(yī)結(jié)合治療小兒原發(fā)性腎病綜合征提供科學(xué)依據(jù)。 方法 選用國(guó)內(nèi)外多個(gè)權(quán)威數(shù)據(jù)庫(kù)為資料源,對(duì)國(guó)內(nèi)外近十年間(2001-2011)已發(fā)表的臨床研究文獻(xiàn)進(jìn)行電子及手工檢索,按照國(guó)際Cochrane協(xié)作網(wǎng)的系統(tǒng)評(píng)價(jià)方法,計(jì)算機(jī)檢索維普期刊全文數(shù)據(jù)庫(kù)(VIP)、中國(guó)知網(wǎng)全文數(shù)據(jù)庫(kù)(CNKI)、萬(wàn)方數(shù)據(jù)庫(kù)、中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù)(CBM); Pubmed(1979-2011)、醫(yī)知網(wǎng)等數(shù)據(jù)庫(kù),及學(xué)術(shù)會(huì)議資料和學(xué)位論文。手工檢索2011年下半年的10余種中文核心期刊。對(duì)所納入的研究進(jìn)行方法學(xué)質(zhì)量評(píng)價(jià),并選取質(zhì)量良好的隨機(jī)對(duì)照試驗(yàn)運(yùn)用Rev.Man5.0.軟件進(jìn)行Meta分析。 結(jié)果 共檢索到18個(gè)符合納入標(biāo)準(zhǔn)的臨床試驗(yàn),共計(jì)1081例病人。Meta-分析顯示：在相同的基礎(chǔ)治療上中西醫(yī)結(jié)合組對(duì)小兒PNS的治療與同期平行隨機(jī)對(duì)照的西藥組相比較,顯示了更好的臨床療效,更好地改善癥狀體征,降低24h尿蛋白定量水平、血膽固醇、甘油三酯、尿素氮、血漿比粘度、復(fù)發(fā)率,明顯減少激素的副作用,并增加血漿白蛋白,對(duì)血肌酐、血沉、全血粘度指標(biāo)無(wú)統(tǒng)計(jì)學(xué)意義。但納入的文獻(xiàn)方法學(xué)質(zhì)量評(píng)價(jià)較低。 結(jié)論 本研究提示中西醫(yī)結(jié)合組治療小兒PNS與單獨(dú)使用西藥治療結(jié)果相比,可提高臨床療效,減少不良反應(yīng)。但由于納入的臨床試驗(yàn)方法學(xué)質(zhì)量相對(duì)偏低,樣本量偏小,存在多種局限性,故對(duì)這些結(jié)果的解釋?xiě)?yīng)持謹(jǐn)慎態(tài)度。
[Abstract]:Objective to evaluate the efficacy of integrated traditional Chinese and western medicine in the treatment of pediatric primary nephrotic syndrome by reviewing the literature and using the method of evidence-based medicine to provide scientific basis for the treatment of pediatric primary nephrotic syndrome with the combination of traditional Chinese and western medicine. Methods A number of authoritative databases at home and abroad were selected as data sources to carry out electronic and manual retrieval of clinical research literature published in recent ten years (2001-2011), and the systematic evaluation method of international Cochrane cooperation network was used. To search the full text database of Weip journal (VIP), (CNKI), Wanfang database, (CBM); Pubmed (1979-2011, and other databases, as well as academic conference materials and degree papers. Manual retrieval of more than 10 Chinese core journals in the second half of 2011. To evaluate the methodological quality of the included studies, and select a good quality randomized controlled trial with Rev.Man5.0. Software Meta analysis. Results A total of 18 clinical trials that met the inclusion criteria were retrieved. A total of 1081 patients. Meta- analysis showed that the treatment of pediatric PNS in the integrated Chinese and western medicine group was compared with that in the parallel randomized control group in the same basic treatment. It showed better clinical effect, improved symptoms and signs, reduced 24-hour urinary protein levels, serum cholesterol, triglyceride, urea nitrogen, plasma specific viscosity, recurrence rate, significantly reduced side effects of hormones, and increased plasma albumin. There was no significant difference in serum creatinine, erythrocyte sedimentation rate and whole blood viscosity. However, the quality evaluation of literature methodology included is relatively low. Conclusion this study suggests that the combination of traditional Chinese and western medicine in the treatment of children with PNS can improve the clinical efficacy and reduce adverse reactions compared with western medicine alone. However, the quality of clinical trial methodology is relatively low, sample size is small, and there are many limitations, so the interpretation of these results should be cautious.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R726.9

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