六种中成药联合西医常规治疗对儿童紫癜性肾炎疗效差异的网状Meta分析  

Network Meta-Analysis of Efficacy of Six Chinese Patent Medicines Combined with Western Medicine in the Treatment of Henoch-Schonlein Purpura Nephritis in Children

作　　者：张蒙蒙 翟文生[1,2] 李广[1,2] 李冰[1,2] 倪锦玉 任相阁 ZHANG Mengmeng;ZHAI Wensheng;LI Cuang;LI Bing;NI Jinyu;REN Xiangge(School of Pediatrics,Henan University of Chinese Medicine,Zhengzhou 450000;First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000)

机构地区：[1]河南中医药大学儿科医学院,郑州450000 [2]河南中医药大学第一附属医院,郑州450000

出　　处：《中药药理与临床》2023年第7期65-73,共9页Pharmacology and Clinics of Chinese Materia Medica

基　　金：国家自然基金(编号:81873339);河南省中医管理局国家中医临床研究基地科研专项(编号:2018JDZX002)。

摘　　要：目的:通过网状Meta分析的方法评价6种不同中成药治疗儿童紫癜性肾炎的疗效及安全性。方法:检索不同中成药联用常规治疗儿童紫癜性肾炎的随机对照试验,建库至2020年10月1日。经2位研究者独立筛选文献、提取资料和评价纳入研究的偏倚风险后,分别对不同的结局指标进行直接Meta分析和网状Meta分析后制表及绘图。结果:共纳入31篇RCTs,共2450例紫癜性肾炎患儿。网状Meta分析结果显示,6种中成药联合西医常规治疗方案在提高总有效率,降低24 h尿蛋白、尿红细胞计数及血清IL-6含量均优于单纯西医常规治疗。交叉比较结果中,黄葵胶囊联合常规在降低尿红细胞计数方面优于百令胶囊、槐杞黄颗粒和雷公藤多苷片联合常规;肾炎康复片联合常规在降低尿红细胞计数方面优于槐杞黄颗粒和雷公藤多苷片联合常规(P<0.05)。概率排序显示,在总有效率方面,白芍总苷胶囊排第1位;在降低24 h尿蛋白定量、尿红细胞计数方面,黄葵胶囊排第1位。在降低血清IL-6含量方面,雷公藤多苷片排第1位。结论:中成药联合常规治疗可提高儿童紫癜性肾炎的临床治疗效果。Objective:To evaluate the efficacy and safety of six Chinese patent medicines in the treatment of Henoch-Schonlein purpura nephritis(HSPN)in children by network Meta-analysis.Methods:PubMed,Embase,Web of Science,CNKI,Wanfang Data,VIP,and SinoMed were searched for randomized controlled trials(RCTs)of Chinese patent medicines combined with routine western medicine in the treatment of HSPN in children from database inception to October 1,2020.After two investigators independently screened the research articles,extracted the data,and evaluated the bias risks included in the study,the direct Meta-analysis and network Meta-analysis were performed on different outcome indicators,followed by plotting of tables and diagrams.Results:Thirty-one RCTs were selected,involving 2450 HSPN children.The results of the network Meta-analysis showed that six Chinese patent medicines combined with routine western medicine were superior to routine western medicine alone in improving the total effective rate,reducing 24 h urinary protein,red blood cell count in urine,and serum inflammatory factor IL-6.Cross-comparison results indicated that in combination with routine western medicine,Huangkui Capsules were superior to Bailing Capsules,Huaiqihuang Granules,and Tripterygium Glycosides Tablets in reducing red blood cell count in urine,and Shenyan Kangfu Tablets were superior to Huaiqihuang Granules and Tripterygium Glycosides Tablets in reducing red blood cell count in urine.The pairwise comparisons of the remaining medicines indicated no significant difference.Probability ranking showed that Total Glucosides of Paeony Capsules ranked first in terms of improving total effective rate,Huangkui Capsules ranked first in reducing 24 h urine protein and red blood cell count in urine,and Tripterygium Glycosides Tablets ranked first in reducing serum inflammatory factor IL-6.Conclusion:Chinese patent medicine combined with routine western medicine can improve the clinical therapeutic effect in the treatment of HSPN in children.

关 键 词：中成药 网状Meta分析 儿童 过敏性紫癜性肾炎 

分 类 号：R725.9[医药卫生—儿科]