文章摘要
昆仙胶囊治疗肾病综合征有效性和安全性的系统评价
The Efficacy and Safety of Kunxian Capsule for Nephrotic Syndrome:A Systematic Review
投稿时间:2020-01-19  修订日期:2020-01-19
DOI:
中文关键词: [] 昆仙胶囊  肾病综合征  Meta分析  系统评价
英文关键词: 
基金项目:]国家自然科学(81701601)
作者单位E-mail
刘亚飞 郑州大学第一附属医院肾内科 Email:yafeiliutjh@gmail.com 
张哲 郑州大学第一附属医院肾内科 296845071@qq.com 
涂胜豪 华中科技大学同济医学院附属同济医院中西医结合科  
陈哲 华中科技大学同济医学院附属同济医院  
王玉 华中科技大学同济医学院附属同济医院  
吴歌 郑州大学第一附属医院肾内科  
张军军 郑州大学第一附属医院肾内科  
邢国兰 郑州大学第一附属医院肾内科 xgl@zzu.edu.cn 
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中文摘要:
      [] 系统评价昆仙胶囊治疗肾病综合征(NS)的有效性和安全性。通过检索CNKI数据库、万方数据库、VIP数据库、CBM数据库、中国临床试验注册中心、PubMed、Cochrane图书馆和Clinical Trials.gov,纳入昆仙胶囊治疗NS的随机对照临床试验(RCTs)。采用RevMan 5.3软件进行Meta分析。筛选出5个RCTs(437名患者)。把它们分成两个亚组:试验组在对照组基础上加用昆仙胶囊治疗称为A组。试验组用昆仙胶囊代替对照组中的某种药物治疗称为R组。对照组均采用糖皮质激素或糖皮质激素加环磷酰胺或糖皮质激素加中药治疗。与对照组相比,A组显示昆仙胶囊可以显著降低蛋白尿[P < 0.00001,MD = -0.82; 95% CI (-0.98~-0.65)]、降低血肌酐[P < 0.00001,MD = -9.57; 95% CI (-13.12~-6.01)]、降低胆固醇[P = 0.003,MD = -1.40; 95% CI (-2.32~-0.48)]、降低甘油三酯[P = 0.03,MD = -0.97; 95% CI (-1.83~-0.11)]、升高有效率[P < 0.00001,OR = 4.80; 95% CI (2.76~8.36)]。而R组各项指标与对照组相比差异无统计学意义。在肾病综合征治疗中,常规治疗加用昆仙胶囊可显著降低蛋白尿、改善肾功能、降血脂、提高有效率。昆仙胶囊替代某些常规治疗药物无法获得更好的结果。然而,昆仙胶囊治疗肾病综合征的疗效尚需更多高质量、多中心RCTs来进一步证实。
英文摘要:
      []There is growing evidence that kunxian capsule which has been wildly applied in the treatment of immunologic diseases, may be effective in treating nephrotic syndrome (NS). However, the evidence needs to be evaluated by a systematic review and meta-analysis. A literature search was performed using CNKI Database, Wanfang Database, VIP Database, CBM Database, Chinese Clinical Trial Register and PubMed, Cochrane Library, and Clinical Trials.gov. The randomized controlled trials (RCTs) concerning the effects of kunxian capsule in the treatment of NS were included. The RevMan 5.3 software was applied to evaluate the effects. After filtering, six RCTs (involving 437 participants) were included in this study. We divided them into two subgroups for analysis. The experimental group of one subgroup was treated with Kunxian Capsule on the basis of the control group. We called it group A. In the other subgroup, Kunxian capsule replaced a drug of the control group. We called it group R. The control group was treated with glucocorticoid or glucocorticoid plus cyclophosphamide or glucocorticoid plus traditional Chinese medicine. In comparison with conventional therapies, group A lowered 24-hour urinary protein [P < 0.00001; MD = ? 0.82; 95% CI (?0.98, ?0.65) ], decreased serum creatinine [P < 0.00001; MD = ?9.57; 95% CI (?13.12, ?6.01)], reduced cholesterol [P = 0.003, MD = -1.40; 95% CI (?2.32, ?0.48)], declined triglyceride [P = 0.03, MD = -0.97; 95% CI (?1.83, ?0.11)], and improved overall effective rate [P < 0.00001; odds ratio = 4.80; 95% CI (2.76, 8.36)]. However, there was no statistical difference in the outcomes of group R. Kunxian capsule is likely to be effective, added to conventional therapies, in the treatment of NS through lowering proteinuria and improving renal function. However, Kunxian Capsule cannot get better outcomes by replacing conventional therapies. Therefore, the efficacy of Kunxian capsule should be estimated by more large-sample RCTs.
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