摘要
目的:系统评价猪苓汤联合西医常规疗法治疗慢性肾小球肾炎的临床疗效及安全性,为指导临床应用提供循证医学证据。方法:计算机检索五大常用数据库,检索时间截止至2019年7月1日,收录猪苓汤联合猪苓汤联合西医常规疗法治疗慢性肾小球肾炎的随机病例对照试验(RCTs),运用Cochrane协作网的偏倚风险评估量表评估纳入研究的方法学质量,运用RevMan 5.3软件进行数据分析。结果:本研究共纳入13篇符合最终标准的文献,共942例患者,Meta分析显示,与单用西医常规疗法相比,猪苓汤联合西医常规疗法能提高临床总有效率[RR=1.27,95%CI(1.19~1.35)],降低24 h尿蛋白[MD=-0.38,95%CI(-0.51,-0.26)],差异有统计学意义(P<0.05);不良反应的发生率[RR=0.25,95%CI(0.12~0.53)],差异有统计学意义(P<0.05)。结论:猪苓汤联合西医常规疗法治疗慢性肾小球肾炎疗效确切,且在降低24 h尿蛋白和减少不良反应方面与单用西医常规疗法比较优势明显。但由于纳入研究质量低,样本量较少,猪苓汤加减联合西医常规疗法治疗慢性肾小球肾炎的临床疗效及安全性仍需设计良好、大样本的随机对照试验进一步支持。
Objective:To systematically evaluate the clinical therapeutic effects and safety of the Zhuling Decoction combined with conventional Western medicine therapy on chronic glomerulonephritis,and to provide evidence-based medicine evidence to guide clinical application.Methods:The 5 commonly used database with the retrieval time ending on July 1 st,2019 were searched to identify all randomized controlled trials(RCTs)of Zhuling Decoction combined with conventional Western Medicine therapy on chronic glomerulonephritis.The Cochrane collaboration bias risk assessment scale was used to evaluate the methodological quality of the included studies and RevMan 5.3 software was used for data analysis.Results:This study included a total of 13 papers that met the final standard,and a total of 942 patients.Meta-analysis showed that compared with the conventional Western medicine therapy alone,Zhuling Decoction with conventional Western medicine therapy may improve the clinical total effective rate[RR=1.27,95%CI(1.19~1.35)],reduce the 24-hours urinary protein [MD=-0.38,95%CI(-0.51,-0.26)],and the difference was statistically significant(P<0.05);The incidence of adverse reactions[RR=0.25,95%CI(0.12~0.53)],and the difference was statistically significant(P<0.05).Conclusion:The Zhuling Decoction combined with conventional Western medicine therapy has definite therapeutic effects on chronic glomerulonephritis,and it has obvious advantages over conventional Western medicine treatment alone in reducing 24-hour urinary protein and reducing adverse reactions.But due to the low quality of the included studies and the small sample size,the clinical therapeutic effects and safety of Zhuling Decoction combined with conventional Western medicine therapy for chronic glomerulonephritis still need to be further supported by well-designed,large sample randomized controlled trials.
作者
张珊珊
王希
王腾
张丽芬
ZHANG Shanshan;WANG Xi;WANG Teng;ZHANG Lifen(Beijing University of Chinese Medicine Third Affiliated Hospital,Beijing 100029,China)
出处
《世界中医药》
CAS
2020年第9期1306-1311,共6页
World Chinese Medicine
基金
北京中医药大学青年教师项目(2018-JYBZZ-JS168)。
关键词
猪苓汤
西医常规疗法
慢性肾小球肾炎
META分析
Zhuling Decoction
Conventional Western medicine therapy
Chronic glomerulonephritis
Meta-analysis
