雷公藤多苷片治疗肾病综合征增效减毒作用系统评价

A systematic review of the synergism and attenuation effects of Tripterygium Glycosides Tablet on the nephrotic syndrome

关键词:  雷公藤多苷  肾病综合征  系统评价

Key words:  Tripterygium Glycosides  nephrotic syndrome  systematic review

摘要:

[目的] 根据雷公藤多苷片治疗肾病综合征有效性和安全性的系统综述，评价雷公藤多苷片的增效减毒作用。[方法] 制订检索策略，检索国内外数据库，经过多层筛选，保留符合纳入标准的原始研究，使用RevMan软件对其进行Meta分析。[结果] Meta分析结果表明，两组完全缓解率有显著性差异[RR=1.51，95% CI（1.33，1.70），P<0.000 01]，试验组优于对照组。在剔除异质性文献后，治疗后两组24 h尿蛋白有显著性差异[MD=-0.53，95% CI（-0.61，-0.44），P<0.000 01]，试验组优于对照组。无论是否剔除异质性文献，两组不良反应发生率均无统计学差异[剔除后结果RR=0.88，95% CI（0.65，1.19），P>0.05]，无法说明试验组优于对照组。[结论] 在基础治疗或常规治疗的基础上加用雷公藤多苷有增效作用，但尚不能证明减毒作用。

Abstract:

[Objective] To evaluate the synergistic and attenuating effects of Tripterygium Glycosides (TG) based on a systematic review of the efficacy and safety of TG in the treatment of nephrotic syndrome. [Methods] The search strategy was developed,and the domestic and foreign databases were searched. After the multi-layer screening,the original research that met the exclusion criteria was retained,and Meta-analysis was performed using Revman software. [Results] The Meta-analysis showed the test group was superior to the control group. There was a significant difference in complete remission rates between the two groups[RR=1.51,95%CI (1.33,1.70),P<0.000 01],and the test group was superior to the control group. After the heterogeneous literature was removed,there was a significant difference in 24 h urine protein between the two groups[MD=-0.53,95%CI (-0.61,-0.44),P<0.000 01]. The test group was superior to the control group. Regardless of whether or not the heterogeneity literature was excluded,there was no significant difference in the incidence of adverse reactions between the two groups[RR=0.88,95%CI (0.65,1.19),P=0.41,P>0.05]. It cannot be stated that the test group is superior to the control group. [Conclusion] The addition of TG on the basis of basic or conventional treatment has a synergistic effect,but it has not been proven to reduce the toxicity.