雷公藤制剂治疗过敏性紫癜肾炎有效性与安全性的meta分析  

Efficacy and Safety of Tripterygium Wilfordii Preparation in the Treatment of Henoch Schonlein Purpura Nephritis: a Meta-analysis

作　　者：沈一凡 韩琳[1] 郝改梅 贾奇 秦明臻 孟佳 张晓宇[1] 秦建国[3] SHEN Yifan;HAN Lin;HAO Haimei(Beijing University of Chinese Medicine,Beijing,100029)

机构地区：[1]北京中医药大学,北京100029 [2]中国中医科学院中医基础理论研究所,北京100700 [3]北京中医药大学东方医院,北京100078

出　　处：《中国中西医结合肾病杂志》2022年第1期20-26,共7页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：北京市第四批师承“中医双百工程”。

摘　　要：目的:对雷公藤制剂治疗过敏性紫癫肾炎的有效性和安全性进行meta分析。方法:检索PubMed、EMBASE、The Cochrane Library、CNKI、VIP、WangFang Data和CBM数据库,收集雷公藤制剂治疗过敏性紫癫肾炎的干预性研究,由2名研究者独立筛选文献、提取资料,采用Revman5.3软件进行meta分析。结果:纳入33篇文献,研究对象共计2 712例,文献偏倚风险评价质量均较低:meta分析结果显示:试验组临床有效率优于对照组(P<0.01),试验组改善蛋白尿(P<0.01),尿红细胞(P<0.01),血IgA(P<0.01)均优于对照组,试验组肝功能损伤(P<0.01)和白细胞减少(P<0.01)均多于对照组,在儿童中尤为明显。结论:雷公藤制剂能改善HSPN蛋白尿和血尿,降低血IgA,但存在肝功能损伤和血白细胞减少的副作用,尤其是在HSPN儿童中,临床实践中因注意使用剂量和时间,并定期监测和及时处理相关不良反应。Objective:To evaluate the efficacy and safety of Tripterygium wilfordii preparation in the treatment of HSPN. Methods:PubMed, EMBASE, the Cochrane Library, CNKI, VIP, Wangfang data and CBM databases were searched to collect the intervention studies of Tripterygium wilfordii preparation in the treatment of HSPN. Two researchers independently screened the literature and extracted the data. Revman5.3 software was used for meta-analysis. Results:A total of 2 712 cases were included in 33 literatures, and the risk of literature bias was low: the results of meta-analysis showed that the clinical effective rate of the experimental group was better than that of the control group(P<0.01), the experimental group improved proteinuria(P<0.01), urinary red blood cells(P<0.01), blood IgA(P<0.01). The liver function damage(P<0.01) and leucopenia(P<0.01) in the experimental group were more than those in the control group, especially in children. Conclusion:Tripterygium wilfordii preparation can improve proteinuria and hematuria of HSPN, reduce blood IgA, but there are side effects of liver function damage and leukopenia, especially in children with HSPN. In clinical practice, we should pay attention to the dosage and time of use, regularly monitor liver function and blood routine, and timely deal with related adverse reactions.

关 键 词：雷公藤制剂 过敏性紫癫肾炎 META分析 

分 类 号：R277.5[医药卫生—中医学]