肾炎康复片治疗紫癜性肾炎的系统评价

A systematic review of Shenyan Kangfu Tablet in the treatment of henoch-schonlein purpura nephritis

关键词:  肾炎康复片  紫癜性肾炎  临床疗效  系统评价  Meta分析

Key words:  Shenyan Kangfu Tablet  henoch-schonlein purpura nephritis  clinical efficacy  systematic review  Meta analysis

摘要:

[目的] 系统评价肾炎康复片治疗紫癜性肾炎的疗效及安全性。[方法] 计算机检索中国知网（CNKI）、维普（VIP）、万方（Wanfang）、中国生物医学文献服务系统（SinoMed）、PubMed、Cochrane Library、Web of Science，检索时间为建库至2023年6月20日，搜集关于肾炎康复片治疗紫癜性肾炎的随机对照试验（RCT）。由两名研究者独立筛选文献、提取数据，采用Cochrane推荐的风险偏倚评估工具ROB2评估文献的偏倚风险，随后交叉核对。应用RevMan 5.4软件进行统计分析，对肾炎康复片治疗紫癜性肾炎的疗效及安全性进行系统评价。[结果] 纳入9篇文献，样本量共853例。总体偏倚风险中，2项研究评为高偏倚风险，7项研究评为有一定偏倚风险。Meta分析结果提示，肾炎康复片能够提升治疗紫癜性肾炎患者的临床疗效[RR=1.19，95%CI（1.10，1.30），P<0.000 1]，降低24 h尿蛋白定量[SMD=-0.78，95%CI（-1.01，-0.56），P<0.000 01]，改善蛋白尿疗效[RR=2.23，95%CI（1.77，2.83），P<0.000 01]，降低尿红细胞计数[SMD=-0.70，95%CI（-1.04，-0.37），P<0.000 1]，改善血尿疗效[RR=1.66，95%CI（1.05，2.60），P=0.03]。肾炎康复片联合西医常规治疗的不良事件较少。[结论] 肾炎康复片在紫癜性肾炎患者的治疗中安全有效，受纳入研究数量和质量的限制，该结论尚待更多高质量研究予以验证。

Abstract:

[Objective] To evaluate the clinical efficacy and safety of Shenyan Kangfu Tablet in the treatment of henoch-schonlein purpura nephritis. [Methods] The randomized controlled trials（RCTs） of Shenyan Kangfu Tablets in the treatment of henoch-schonlein purpura nephritis were retrieved from CNKI，VIP，Wanfang，SinoMed，PubMed，Cochrane Library and Web of Science from the establishment of the database to June 20，2023. Two reviewers independently screened literatures，extracted the data，and assessed the risk of bias of the studies by using the bias risk assessment tool ROB2 recommended by Cochrane，and then cross-checked. RevMan 5.4 software was used for statistical analysis to systematically evaluate the efficacy and safety of Shenyan Kangfu Tablets in the treatment of henoch-schonlein purpura nephritis. [Results] Nine articles were included，with a total sample size of 853 cases. Of the overall risk of bias，2 studies were rated as high risk of bias and 7 studies were rated as having some risk of bias. The results of Meta-analysis showed that Shenyan Kangfu Tablets could improve the clinical efficacy in the treatment of patients with henoch-schonlein purpura nephritis [RR=1.19，95%CI（1.10，1.30），P<0.00 01]，reduce the 24-h urine protein quantification [SMD=-0.78，95%CI（-1.01，-0.56），P<0.000 01]，improve the efficacy of proteinuria [RR=2.23，95% CI（1.77，2.83），P<0.000 01]，reduce the urine red blood cell count [SMD=-0.70，95%CI（-1.04，-0.37），P<0.00 01]，and improve the efficacy of hematuria [RR=1.66，95%CI（1.05，2.60），P=0.03]. The adverse events of Shenyan Kangfu Tablets combined with conventional western medicine were fewer. [Conclusion] Shenyan Kangfu Tablet is safe and effective in the treatment of patients with henoch-schonlein purpura nephritis，which is limited by the number and quality of included studies. This conclusion needs to be verified by more high-quality studies.