参芪地黄汤治疗膜性肾病的Meta分析  

A Meta Analysis of Shenqi Dihuang Decoction in Treatment of Membranous Nephropathy

作　　者：廖健 凌丽[1] LIAO Jian;LING Li(Department of Nephrology,Neijiang Hospital of Traditional Chinese Medicine,Neijiang,Sichuan,641000,China)

机构地区：[1]内江市中医医院肾内科,四川内江641000

出　　处：《中外医疗》2025年第8期23-29,共7页China & Foreign Medical Treatment

基　　金：成都中医药大学“杏林学者”科研项目(YYZX2021143)。

摘　　要：目的从循证医学角度对参芪地黄汤治疗膜性肾病的疗效及安全性进行评估。方法网络检索PubMed、CCTR、EMBASE和中国知网、维普和万方数据库中关于参芪地黄汤治疗膜性肾病的随机对照研究,两名独立研究者对文献进行筛选和资料提取,并做质量评价。采用RevMan 5.4软件对纳入的研究进行Meta分析;比较参芪地黄汤干预的研究组与对照组总有效率、尿蛋白定量(urinary total protein,UTP)、血浆白蛋白(albumin,ALB)、血清肌酐(serum creatinine,SCR)、抗磷脂酶A2受体抗体(phospholipase A2 receptor,PLA2R)及不良反应。结果共纳入8个随机对照研究,退出9例,共纳入患者457例,文献方法质量学评价纳入文献质量一般,盲法普遍缺失,发表偏倚小;Meta分析显示纳入研究基线一致,研究组总有效率高于对照组[MD=4.42,95%CI(2.66,7.36),P<0.00001];研究组UTP明显低于对照组[MD=-1.07,95%CI(-1.30,-0.83),P<0.00001];研究组ALB高于对照组[MD=4.27,95%CI(2.90,5.63),P<0.00001];两组的SCR[MD=-4.20,95%CI(-9.35,0.96),P=0.11]及PLA2R[MD=-1.70,95%CI(-4.14,0.75),P=0.17]比较,差异均无统计学意义;研究组感染率低于对照组[MD=0.24,95%CI(0.11,0.52),P=0.0003]。结论参芪地黄汤有助于提高疗效、降低UTP、增加ALB、减少感染率,但对SCR及PLA2R影响不大。Objective To evaluate the effects and safety of Shenqi Dihuang decoction in the treatment of membranous nephropathy from the perspective of evidence-based medicine.Methods PubMed,CCTR,EMBASE and CNKI,VIP and WANFANG databases were searched for randomized controlled trials on Shenqi Dihuang decoction in the treatment of membranous nephropathy.Two independent researchers screened the literature and extracted the data,and evaluate the quality.RevMan 5.4 software was used for meta analysis of the included studies.The total effective rate,urinary total protein(UTP),albumin(ALB),serum creatinine(SCR),and phospholipase A2 receptor(PLA2R)and adverse reactions were compared between the experimental group and the control group.Results A total of 457 patients were included in 8 randomized controlled trials,and 9 patients were withdrawn.The quality of the included literatures was general,the blinding method was generally missing,and the publication bias was small.Meta-analysis showed that the baseline of the included studies was consistent,and the total effective rate of the experimental group was higher than that of the control group[MD=4.42,95%CI(2.66,7.36),P<0.00001];UTP of the experimental group was significantly lower than that of the control group[MD=-1.07,95%CI(-1.30,-0.83),P<0.00001];ALB in the experimental group was higher than that in the control group[MD=4.27,95%CI(2.90,5.63),P<0.00001];there was no significant difference in SCR[MD=-4.20,95%CI(-9.35,0.96),P=0.11]and PLA2R[MD=-1.70,95%CI(-4.14,0.75),P=0.17]between the two groups.The infection rate in the experimental group was lower than that in the control group[MD=0.24,95%CI(0.11,0.52),P=0.0003].Conclusion Shenqi Dihuang decoction can improve the reffective rate,reduce UTP,increase ALB and reduce infection rate,but has little effect on SCR and PLA2R.

关 键 词：参芪地黄汤 膜性肾病 META分析 疗效 安全性 

分 类 号：R2[医药卫生—中医学]