文章摘要
王慧,杨继红,杜俊杰,刘颖.雷公藤多苷联合糖皮质激素治疗IgA肾病效果的Meta分析[J].中国临床保健杂志,2020,23(6):780-784.
雷公藤多苷联合糖皮质激素治疗IgA肾病效果的Meta分析
Efficacy and safety of tripterygium glycosides combined with glucocorticoids in the treatment of IgA nephropathy:a meta-analysis
投稿时间:2020-07-19  
DOI:10.3969/J.issn.1672-6790.2020.06.014
中文关键词: 肾小球肾炎,IGA  糖皮质激素类  雷公藤  药物疗法  Meta分析
英文关键词: Glomerulonephritis,IGA  Glucocorticoids  Tripterygium Wilfordii  Drug therapy  Meta-analysis 〖FL
基金项目:国家自然科学基金(81373803)
作者单位E-mail
王慧 北京医院肾内科 国家老年医学中心 中国医学科学院老年医学研究院,北京 100730 yangjihong3078@bjhmoh.cn 
杨继红 北京医院肾内科 国家老年医学中心 中国医学科学院老年医学研究院,北京 100730 yangjihong3078@bjhmoh.cn 
杜俊杰 北京医院肾内科 国家老年医学中心 中国医学科学院老年医学研究院,北京 100730 yangjihong3078@bjhmoh.cn 
刘颖 北京医院肾内科 国家老年医学中心 中国医学科学院老年医学研究院,北京 100730 yangjihong3078@bjhmoh.cn 
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中文摘要:
      目的 探讨雷公藤多苷联合糖皮质激素治疗和单独使用雷公藤多苷或糖皮质激素治疗IgA肾病的疗效和安全性。方法 搜索电子数据库,将符合纳入标准的随机对照试验纳入研究并由两名独立研究者分别进行文献质量评价和数据的提取,数据分析采用Review Manager 5.3和Stata 14.0软件进行分析。分析的指标为24 h尿蛋白、血肌酐、尿红细胞及不良反应。结果 共纳入9项研究。Meta结果显示联合治疗组24 h蛋白尿低于单药治疗组[MD=-0.45,95%CI:-0.50~-0.40,P<0.001]。联合治疗组血肌酐低于单药治疗组[MD=-14.79,95%CI:-18.18~-11.36),P<0.001]。联合治疗组尿红细胞数低于单药治疗组[MD=-21.56,95%CI:-33.49~-9.63),P<0.001]。联合治疗组的不良反应少于单药治疗组[RR=0.49,95%CI:0.35~0.68,P<0.001]。结论 雷公藤多苷和糖皮质激素在IgA肾病的治疗中具有协同作用,联合治疗效果优于单药治疗,联合治疗不良反应低于单药治疗组。
英文摘要:
      Objective To compare the efficacy and safety of tripterygium glycosides combined with glucocorticoids combined with tripterygium glycosides or glucocorticoids alone for IgA nephropathy.Methods Several electronic database were searched and randomized controlled trials meeting the inclusion criteria were included in the study.Two independent researchers were used to evaluate the quality of the literature and extract the data.The data were analyzed using Review Manager 5.3 and Stata 14.0 software.The outcome indicators analyzed were 24 hour urinary protein,serumcreatinine,urinary red blood cells,and adverse events.Results A total of 9 studies were included.The Meta results showed that the 24-hour urinary protein in the combination therapy group was lower than that in the monotherapy group[MD=-0.45,95%CI(-0.50,-0.40),P<0.001].Serum creatinine in the combination treatment group was lower than that in the monotherapy group[MD=-14.79,95%CI(-18.18,-11.36),P<0.001].The number of urine red blood cells in the combination treatment group was lower than that in the monotherapy group[MD=-21.56,95%CI(-33.49,-9.63),P<0.001].The side effects of the combination therapy group were less than those of the monotherapy group[RR=0.49,95%CI(0.35,0.68),P<0.001].Conclusion Tripterygium glycosides and glucocorticoids is a synergistic effect in the treatment of IgA nephropathy,and the combined treatment effect is better than monotherapy.The total adverse reactions of combination therapy were lower than those of monotherapy group.
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