中西医结合治疗成人难治性肾病综合征的荟萃分析

目的评价中西医结合治疗成人原发性难治性肾病综合征（RNS）的临床疗效以及不良反应。方法采用荟萃（Meta）分析的方法，对近12年中西医结合治疗成人RNS的随机对照研究（RCT）进行系统评价。采用电子检索Medline、中国生物医学文献数据库（CBMdisk）、万方数据库、西文生物医学期刊文献数据库（EMCC），并手工检索近6个月中西医结合杂志和国内肾脏疾病相关杂志的8种核心期刊；提取和比较中西医结合治疗成人RNS患者的RCT的数据；采用Cochrane协作网专用软件RavMan4．2进行统计分析。结果检索符合纳入标准的RCT研究13篇，共777例患者。Meta分析显示中西医结合治疗对成人RNS的治疗与同期平行随机对照的西药治疗组相比较，显示更好的临床疗效，降低24h尿蛋白定量及总胆固醇水平、提高血浆白蛋白水平；同时也降低不良反应的发生率。结论中西医结合治疗RNS与单独使用泼尼松、环磷酰胺等西药相比较，临床疗效明显提高、不良反应减少。

Meta analysis of integrated traditional chinese and western medicine in the treatment of refractory nephrotic syndrome in adults

Objective To evaluate the curative effect and side effects of integrated traditional chinese and western medicine in the treatment of refractory nephrotic syndrome （RNS） in adults. Method Randomized controlled trial （RCT） were applied for systematic reviews. Electronic and man- ual retrieve from Medline, Cochrane Library, CBMdisk, Wan fang Data and relevant medical journals in China were applied to search RNS, and the RCT were analyzed with RavMan 4. 2. Result There were 13 RCT with 777 cases involved. Meta analyses revealed that the combined treatment could improve the therapeutic effects of prednisone and immunosuppressant for RNS, and reduce its recurrence. Com- bined treatment could also decrease 24 h proteinuria content and the plasma levels of total cholesterol, and increase the albumin. ＂Funnel plot＂ showed dissymmetry, which may be related to publication bias and low quality of methodology. Conclusion Comparing to the treatment of RNS in adults with western medicine alone,combined treatment can obtain more satisfactory curative effects, and also can reduce the side effects of using prednisone and immunosuppressant.