槐杞黄颗粒对原发性肾病综合征患儿细胞与体液免疫调节作用的Meta分析

The regulatory effects of Huaiqihuang Granules on cellular and humoral immunity in children with primary nephrotic syndrome:A Meta-analysis

关键词:  槐杞黄颗粒  原发性肾病综合征  细胞免疫  体液免疫  Meta分析

Key words:  Huaiqihuang Granules  primary nephrotic syndrome  cellular immunity  humoral immunity  Meta-analysis

摘要:

[目的] 系统的评价槐杞黄颗粒在原发性肾病综合征患儿的细胞与体液免疫中的辅助性调节作用。[方法] 通过检索英文数据库（PubMed、EMbase、Web of Science、Cochrane）和中文数据库（CNKI、Wanfang Database、VIP、SinoMed），纳入所有关于槐杞黄颗粒干预原发性肾病综合征患儿的临床随机对照试验。主要结局指标包括总有效率、体液免疫（IgA、IgG、IgM）和细胞免疫（CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺、NK细胞），次要结局指标包括水肿消退时间、尿蛋白转阴时间、感染发生率、复发率和不良反应发生率。[结果] 纳入22项研究，1 587例原发性肾病综合征患儿，对照组以糖皮质激素类药物作为干预措施，治疗组采用糖皮质激素类药物联合槐杞黄颗粒治疗。研究结果显示：相比于对照组，治疗组能够明显改善细胞免疫（提升CD3⁺、CD4⁺、CD4⁺/CD8⁺、NK细胞，降低CD8⁺）与体液免疫（提升IgA和IgG）、缩短水肿消退和尿蛋白转阴时间、降低感染发生和疾病复发率、提升临床总有效率（P<0.05），且两组均具有较好的安全性。[结论] 从目前Meta分析的结果来看，在糖皮质激素类药物的基础上联合槐杞黄颗粒一定程度上能够改善原发性肾病综合征患儿的细胞免疫与体液免疫改善临床症状，提升临床疗效，但受限于研究的质量的原因，未来仍需要更高质量的临床研究予以证实。

Abstract:

[Objective] To systematically evaluate the adjuvant regulatory effects of locust yellow granules in cellular and humoral immunity in children with primary nephrotic syndrome. [Methods] All clinical randomized controlled trials on the intervention of Huaiqihuang Granules in children with primary nephrotic syndrome were included by searching English（PubMed，EMBASE，Web of Science，the Cochrane Library） and Chinese databases（CNKI，Wanfang Database，VIP，SinoMed）. The primary outcome indicators included overall effective rate，humoral immunity（IgA，IgG，IgM），and cellular immunity（CD3⁺，CD4⁺，CD8⁺，CD4⁺/CD8⁺，NK cells），and the secondary outcome indicators included time to regression of edema，time to conversion of urinary proteins，incidence of infections，relapse rate，and incidence of adverse reactions. [Results] Twenty-two studies with 1 587 children with primary nephrotic syndrome were included. The control group was treated with glucocorticosteroids as an intervention，and the treatment group was treated with glucocorticosteroids in combination with Huaiqihuang Granules. The results of the study showed that compared with the control group，the treatment group was able to significantly improve cellular（boosting CD3⁺，CD4⁺，CD4⁺/CD8⁺，NK cells，and lowering CD8⁺） and humoral immunity（boosting IgA and IgG），shorten the time of edema subsidence and urinary protein turnover，reduce the incidence of infections and recurrence of the disease，and improve the overall clinical effectiveness rate（P<0.05），and both groups had a better safety. [Conclusion] From the results of the meta-analysis，the combination of Huaiqihuang Granules with glucocorticoid drugs can improve the cellular and humoral immunity of children with primary nephrotic syndrome to a certain extent，reduce the clinical symptoms，and improve the clinical efficacy. Higher-quality clinical studies are needed in the future to confirm the results.