雷公藤联合激素治疗肾病综合征疗效的Meta综合分析  

Meta Analysis of Tripterygium Wilfordii Combined Hormone Therapy in NS Patients

作　　者：黄琼[1] 曾庆明 郑义侯[3] 熊吉龙[3] 

机构地区：[1]江西中医药大学,江西南昌310000 [2]广东省深圳市罗湖区中医院,广东深圳518000 [3]深圳市中医院,广东深圳518000

出　　处：《辽宁中医药大学学报》2015年第7期145-148,共4页Journal of Liaoning University of Traditional Chinese Medicine

摘　　要：目的:主要评价雷公藤多苷联合糖皮质激素治疗肾病综合征分别在降低24 h尿蛋白定量、甘油三酯、血肌酐,升高血浆白蛋白的疗效上是否有差异;再次确定能否提高疗效、减少复发率及对副反应进行分析。方法:采用电子检索Medline、Embase、中国生物医学文献数据库CBM disc、VIP数据库、中国循证医学/Cochrane中心数据库CEBM/CCD图书馆等数据库和手工检索中医期刊、中西医结合杂志和国内肾脏疾病相关的杂志,创刊至2014年6月截止。搜集和比较雷公藤多苷联合激素与单纯激素治疗成人原发性肾病综合征随机对照试验,采用Cochrane协作网专用软件Rev Man 5.2进行统计分析。结果:检索符合RCTs纳入标准的随机对照试验13篇,共898例病人,meta分析结果雷公藤多苷联合激素治疗肾病综合征,在降低24 h蛋白尿定量、升高血浆白蛋白水平较对照组更具有改善作用,在降低甘油三酯和肌酐方面则无明显差异。雷公藤多苷联合糖皮质激素与单纯使用激素相比,明显提高总有效率、降低复发率和减少副作用及不良反应。结论:雷公藤多苷联合激素治疗肾病综合征在降低24 h蛋白尿定量、升高血浆白蛋白水平较单纯激素更具有改善作用,是一种有前景的治疗手段,有待于进一步挖掘雷公藤治疗肾病综合征机制、临床应用方式、减少不良反应,进而取得更好的治疗效果。Objective：Whether there are differences effect of tripterygium wilfordii combined with glucocorticoids in the treatment of nephrotic syndrome in lower quantitative measurement of 24 hours urinary protein,triglycerides,serum creatinine and elevated plasma albu min or not;make sure it can improve the curative effect again,reduce the recurrence rate and analyzed the side reaction.Methods：Electronic and manual retrieve of Medline,Embase,CBM disc,VIP database,CEBM/CCD,Cochrane library and hand searching for Chinese Journal of integrated traditional Chinese and Western medicine and relevant medical journals in China which published until 2014 June to search the RCTs of tripterygium glycosides combined with prednisone and the prednisone treatment of adult primary nephrotic syndrome randomized controlled trial,and the RCTs were analysed with Rev Man 5.2. Results：There were 14 randomized controlled trials with 524 cases involved. Meta-analysis showes that Tripterygium wilfordii combined with prednisone therapy for NS had better effect in decreasing 24-hour proteinuria content,increase the plasma albu min level than the control group,in terms of lower triglycerides and creatinine were not significantly difference.Tripterygium glycosides combined with prednisone obviously increase the total effective rate,reduce the recurrence rate and reduce the side effects and adverse reactions compared with single prednisone. Conclusion：Tripterygium wilfordii combined with prednisone therapy for NS had better effect in decreasing 24-hour proteinuria content,increase the plasma albu min level than single prednisone.It is a promising treatment which need to be further discover mechanism of tripterygium wilfordii in the treatment of nephrotic syndrome,including the way of clinical application and reducing adverse reactions for a better therapeutic effect.

关 键 词：雷公藤多苷激素 肾病综合征 疗效综合分析 

分 类 号：R692[医药卫生—泌尿科学]