益肾活血药治疗小儿原发性肾病综合征的系统评价

目的评价益肾活血药治疗小儿原发性肾病综合征(NS)的临床疗效和安全性。方法运用循证医学Cochrance系统评价方法,检索PubMed、中国知网期刊全文数据库、重庆维普全文期刊数据库、中国生物医学文献数据库、中国博士硕士学位论文全文数据库等,检索时间2000-01/2011-07,纳入国内外有关益肾活血药治疗NS的随机对照试验。应用Jadad评分评价纳入文献质量,选择胆固醇、三酰甘油、血栓素B2、6-酮-前列腺素1a、CD3、CD4、CD8、CD4/CD8、复发率、临床疗效、血浆白蛋白、24h尿蛋白定量、皮质醇等13项结局指标,运用RevMan5.0软件进行Meta分析。结果共纳入13个随机对照试验,共计725例患儿。Jadad评分均为3分。Meta分析显示,除皮质醇1项指标与对照组比较差异无统计学意义外,其他指标差异均有统计学意义(P0.05)。西药联合益肾活血中药治疗NS,在一定程度上优于西药治疗,且未见不良反应,安全可靠。结论现有证据表明,益肾活血药治疗NS有一定的效果。受纳入研究数量与质量限制,其疗效和安全性期待更多高质量随机双盲对照试验加以证实。

The systematic review on medicine for tonifying kidney and promoting blood flow in the treatment of primary nephrotic syndrome in children

Objective To assess the curative effect and the security of the medicine for tonifying kidney and promoting blood flow in the treatment of primary nephrotie syndrome in childreru Methods Through retrieval Cochrane, MEDLINE, CNKI, VIP, CBM and Full-text data base of Chinese Drs and Lies were searched,and the search time was from Jan 2000 to July 2011. RCTs related medicines for tonifying kidney and promoting blood flow of in primary nephrotic syndrome in children were collected. The literature quality was evaluated by Jadad Score and the data analysis was made by RevMan 5. 0 software. Thirteen indexes were selected namely, TC, TG, TXB2,6-keto-PGFla, CD3, CD4, CDS, CD4/CD8, ALB, 24 h urine protein, compound F, re- lapse rate and clinical manifestation. Results Thirteen studies were included in the analysis, totally 725 pa- tients. Jadad Scores were all 3 points. Meta analysis showed： except for compound F, the other 12 indexes showed obvious difference from the control group（P〈0.05）. To some degree,the curative effect of Western medicine combined with the medicine for tonifying kidney and promoting blood flow was better than solitary western medicine,and there was fewer adverse reactions, so ifs safe and reliable. Conclusions Present evi- dence shows that tile medicine drug for tonifying kidney and promoting blood flow has effect on curing pri- mary nephrotic syndrome in children. Limited by quantity and quality of the literature searched,its curative effect and safety need more high-quailty RCT experiments.