中成药注射液治疗IgA肾病临床疗效的网状Meta分析  

Clinical Efficacy of Chinese Patent Medicine Injection in the Treatment of IgA Nephropathy:A Network Meta-analysis

作　　者：林云鑫 黄英杰 黄慈辉 刘家玥 霍晨星 庄泽钦 李丹 杨曙东[3] LIN Yun-Xin;HUANG Ying-Jie;HUANG Ci-Hui;LIU Jia-Yue;HUO Chen-Xing;ZHUANG Ze-Qin;LI Dan;YANG Shu-Dong(The Fourth Clinical Medical School of Guangzhou University of Chinese Medicine,Shenzhen 518033 Guangdong,China;The First Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Dept.of Nephropathy,Shenzhen Traditional Chinese Medicine Hospital,Shenzhen 518033 Guangdong,China)

机构地区：[1]广州中医药大学第四临床医学院,广东深圳518033 [2]广州中医药大学第一临床医学院,广东广州510405 [3]广东省深圳市中医院肾病科,广东深圳518033

出　　处：《广州中医药大学学报》2021年第7期1519-1530,共12页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省自然科学基金项目(编号:2020A1515010152);广东省深圳市卫生系统科研项目(编号:SZLY2018005);广东省中医药局杨文辉广东省名中医传承工作室建设项目(粤中医办函[2019]5号);广州中医药大学第一临床医学院创新强院团队孵化计划项目(编号:2018XXDT01)。

摘　　要：【目的】采用网状Meta分析评价中成药注射液治疗IgA肾病的临床疗效。【方法】计算机检索国内外主要数据库,搜索有关采用中成药注射液联合西医常规治疗对比单用西医常规治疗IgA肾病的临床随机对照试验。逐步筛选纳入文献后进行数据提取及质量评价,采用Stata 15.0软件对数据进行分析。【结果】共纳入临床随机对照试验23篇,包括1709例患者,主要涉及疏血通注射液、川芎嗪注射液、复方丹参注射液、灯盏花素注射液、杏丁注射液、黄芪注射液、参芪扶正注射液7种中成药注射液。与西医常规治疗比较,灯盏花素注射液、参芪扶正注射液、杏丁注射液、川芎嗪注射液、疏血通注射液、黄芪注射液分别联合西医常规治疗均能显著提高总有效率(P<0.05);参芪扶正注射液、川芎嗪注射液、灯盏花素注射液分别联合西医常规治疗均能显著降低血肌肝(SCr)水平(P<0.05);川芎嗪注射液、杏丁注射液、黄芪注射液分别联合西医常规治疗均能显著降低24 h尿蛋白定量(P<0.05);灯盏花素注射液、杏丁注射液、川芎嗪注射液分别联合西医常规治疗均能显著降低血尿素氮(BUN)水平(P<0.05);灯盏花素注射液、黄芪注射液分别联合西医常规治疗均能显著降低尿白蛋白水平(P<0.05)。优选概率排名曲线(the surface under the cumulative ranking curve,SUCRA)分析结果表明,灯盏花素注射液联合西医常规治疗在提升总有效率方面,参芪扶正注射液联合西医常规治疗在降低SCr水平方面,以及杏丁注射液联合西医常规治疗在降低BUN水平方面的疗效最优可能性最大,黄芪注射液联合西医常规治疗在降低24 h尿蛋白及尿白蛋白方面的疗效最优可能性最大。【结论】中成药注射液在治疗IgA肾病方面有显著的临床疗效,该研究结论为临床选方用药提供了一定的循证参考,但仍需更多高质量的临床应用研究加以验证。Objective To systematically evaluate the clinical efficacy of Chinese patent medicine injection in the treatment of IgA nephropathy,so as to provide evidence-based reference for clinical decision-making in the treatment of IgA nephropathy.Methods The clinical randomized controlled trials(RCTs)for the treatment of IgA nephropathy by Chinese patent medicine injection combined with conventional western medicine treatment vs conventional western medicine treatment alone were retrieved from the primary oversea and domestic literature databases.And then the quality evaluation and data extraction were carried out after the included literatures were screened out.The data were processed by Stata15.0 software.Results A total of 23 randomized controlled trials involving 1709 patients were included.And a total of 7 kinds of Chinese patent medicine injections were analyzed,and they were Shuxuetong Injection,Ligustrazine Injection,Compound Danshen Injection,Breviscapine and Sodium Chloride Injection,Xing Ding Injection,Huangqi Injection,Shen Qi Fuzheng Injection.The results showed that in comparison with the conventional western medicine treatment alone,Breviscapine and Sodium Chloride Injection,Shen Qi Fuzheng Injection,Xing Ding Injection,Ligustrazine Injection,Shuxuetong Injection,and Huangqi Injection separately combined with conventional western medicine treatment were effective on increasing the total effective rate(P<0.05);Shen Qi Fuzheng Injection,Ligustrazine Injection,and Breviscapine and Sodium Chloride Injection separately combined with conventional western medicine were effective on decreasing serum creatinine(SCr)level(P<0.05);Ligustrazine Injection,Xing Ding Injection,and Huangqi Injection separately combined with conventional western medicine treatment were effective on decreasing 24-hour urinary protein quantitation(P<0.05);Breviscapine and Sodium Chloride Injection,Xing Ding Injection,and Ligustrazine Injection separately combined with conventional western medicine treatment were effective on decreasing blood

关 键 词：中成药注射液 疏血通注射液 川芎嗪注射液 复方丹参注射液 LGA肾病 西医常规治疗 网状Meta分析 

分 类 号：R256.5[医药卫生—中医内科学] R692.6[医药卫生—中医学]