Department of Pediatrics, Qilu Medical University, Zibo, Shandong, China.
Department of Surgery, Qilu Medical University, Zibo, Shandong, China.
Contrast Media Mol Imaging. 2022 Sep 27;2022:2520367. doi: 10.1155/2022/2520367. eCollection 2022.
To systematically evaluate the efficacy and safety of traditional Chinese medicine (TCM) granules associated with hormones when treating primary nephrotic syndrome (PNS) in children.
Search online databases such as PubMed, EMBASE, ScienceDirect, Cochrane Library, China Knowledge Network Database (CNKI), China VIP Database, Wanfang Database, and China Biomedical Literature Database (CBM) to search for information on the use of hormone-related Chinese medicine granules in the treatment of children with PNS controlled trials. Retrieval time was limited to the period from the date the database was established to the present. Separately, two researchers gathered the data. Statistical software RevMan5.4 was adopted to estimate bias risk in accordance with the Cochrane Handbook 5.3 standard.
Finally, 7 articles were selected with a total sample size of 487 cases. The infection rate, recurrence rate, and adverse reaction rate after treatment were analyzed by meta-analysis. The infection rate and recurrence rate in the study group were notably lower, and the difference was statistically significant ( < 0.05). However, the incidence of adverse reactions exhibited not notably different ( > 0.05). The levels of albumin and blood cholesterol after treatment indicated no statistical difference between the levels ( > 0.05). Meta-analysis was performed on the time to negative urine protein and the time to edema subsidence after treatment. The urine protein negative time and edema subsidence time of the study group were shorter after treatment, but the difference exhibited not notable ( > 0.05). Meta-analysis was performed on the dosage of glucocorticoids after treatment. The dosage of glucocorticoid in the study group was notably lower, and the difference was statistically significant ( < 0.05). The levels of T lymphocytes after treatment were analyzed by meta. T lymphoid level in the study group was notably better after treatment, and the difference was statistically significant ( < 0.05). Further subgroup analysis indicated that the levels of CD3+ and CD4+ in the study group were higher after treatment ( < 0.05), and there exhibited no statistical difference in the levels of CD8+, CD4/CD8+, and CD19 ( > 0.05). Immunoglobulin levels in the study group after treatment were notably better, and the difference was statistically significant ( < 0.05). Further subgroup analysis indicated that the levels of IgA, IgM, and IgG in the study group were notably higher after treatment, and the difference was statistically significant ( < 0.05).
Huai Qi Huang can reduce the recurrence rate of PNS children and the incidence of infection and the dosage of prednisone. A long-term application can improve the cellular and humoral immune function of children with PNS. It has high treatment safety and has no notable effect on plasma cholesterol levels, so it is suitable for clinical application.
系统评价中药颗粒剂联合激素治疗儿童原发性肾病综合征(PNS)的疗效和安全性。
检索 PubMed、EMBASE、ScienceDirect、Cochrane 图书馆、中国知网(CNKI)、中国维普数据库(VIP)、万方数据库和中国生物医学文献数据库(CBM),纳入激素相关中药颗粒剂治疗儿童 PNS 的随机对照试验。检索时间限定为数据库建立至当前。两名研究人员分别收集数据。采用 Cochrane 手册 5.3 标准评估 RevMan5.4 统计软件的偏倚风险。
最终纳入 7 篇文献,共 487 例样本。采用荟萃分析对治疗后感染率、复发率和不良反应率进行分析。研究组的感染率和复发率明显较低,差异具有统计学意义(<0.05)。但是,不良反应发生率差异无统计学意义(>0.05)。白蛋白和血胆固醇水平治疗后差异无统计学意义(>0.05)。对治疗后尿蛋白转阴时间和水肿消退时间进行荟萃分析。研究组治疗后尿蛋白转阴时间和水肿消退时间更短,但差异无统计学意义(>0.05)。对治疗后糖皮质激素剂量进行荟萃分析。研究组糖皮质激素剂量明显较低,差异具有统计学意义(<0.05)。治疗后 T 淋巴细胞水平采用荟萃分析。研究组 T 淋巴细胞水平明显改善,差异具有统计学意义(<0.05)。进一步亚组分析表明,研究组 CD3+和 CD4+水平较高(<0.05),CD8+、CD4/CD8+和 CD19 水平差异无统计学意义(>0.05)。治疗后研究组免疫球蛋白水平明显改善,差异具有统计学意义(<0.05)。进一步亚组分析表明,研究组 IgA、IgM 和 IgG 水平明显升高,差异具有统计学意义(<0.05)。
槐杞黄颗粒能降低儿童 PNS 复发率和感染发生率及泼尼松龙用量,长期应用能改善儿童 PNS 的细胞和体液免疫功能,治疗安全性高,对血浆胆固醇水平无显著影响,适合临床应用。