雷公藤多甙联合糖皮质激素对肾病综合征疗效的Meta分析  

Meta-analysis on efficacy of TG and GC for nephritic syndrome

作　　者：寇长贵[1] 吕晓珍[2] 齐霁[3] 谢冰[1] 于雅琴[1] 

机构地区：[1]吉林大学公共卫生学院流行病与卫生统计学教研室,吉林长春130021 [2]北京大学公共卫生学院流行病与统计学系,北京100083 [3]吉林大学2004级临床医学七年制学生

出　　处：《吉林大学学报（医学版）》2008年第4期671-675,共5页Journal of Jilin University：Medicine Edition

基　　金：吉林省科技厅科技发展计划项目资助课题(200505135)

摘　　要：目的：评价雷公藤多甙（TG）联合糖皮质激素（GC）治疗肾病综合征（NS）是否有助于提高疗效、减少复发，为临床上肾病综合征治疗方案的选择提供指导。方法：按照系统评价的要求电子检索PubMed、Cochrane图书馆、CBMdisc、CNKI、万方数据库等，手工检索《中西医结合杂志》及国内肾脏疾病相关的杂志，搜集和比较TG联合GC与单用GC治疗成人及小儿NS的随机对照试验（RCT）或临床对照试验（CCT）。由2名评价员独立筛选、评价文献和提取数据。采用RevMan4．2软件，对符合纳入标准的9篇文献进行Meta分析。结果：TG联合GC组与GC组相比，总缓解率、半年复发率文献来源具有同质性，前者缓解率高于后者（OR=2．61，95％CI为1．37～4．97），前者半年复发率低于后者（OR=0．18，95％CI为0．09～0．36）。总缓解率、半年复发率“漏斗图”图形基本对称。结论：TG联合GC治疗NS在减少疾病的复发方面具有较好的作用，所纳入文献方法学质量不高，对NS的确切疗效及有关毒副作用有待于设计严格的多中心、大样本、随机双盲临床对照试验进一步证实。Objective To assess the therapeutic effect of tripterygium glycosides （TG） and glucocorticoid （GC） for nephritic syndrome （NS） . Methods Randomized controlled trials （RCT） or clinical controlled trials （CCT） with TG and GC for treatment of NS as treatment group and GC as control group were applied for the systemic review. According to the requirements of Cochrane systematic review, a thorough literature search was performed among PubMed, Cochrane library, CBMdisc, CNKI, Wanfang Database and relevant medical journals in China. Two qualified reviewers reviewed the original articles, extracting data and evaluating the quality independently. With RevMan 4. 2 software, a Meta-analysis was performed on 9 papers which met the inclusion criteria. Results The literatures of remission and recurrence rate had homogeneity. Compared with control group, the incorporation remission rate in treatment group was higher （OR= 2.61, 95 % CI 1.37 - 4.97）, but the incorporation recurrence rate after six months had significant difference （OR = 0. 18, 95% CI 0.09 - 0.36）. Funnel plots were nearly symmetry. Conclusion TG and GC may become a prospect therapy for NS. Their definite effects for NS will be further confirmed by multiple-center, large-sample RCT.

关 键 词：雷公藤多甙 糖皮质激素 肾病综合征 综合分析 

分 类 号：R692[医药卫生—泌尿科学]