Ma Jia, Hou Yan-Jie, Zhang Yi-Ou, Liu Guang-Zhen
Shanxi University of Chinese Medicine Taiyuan 030024, China.
Shanxi Institute of Traditional Chinese Medicine Taiyuan 030012, China.
Zhongguo Zhong Yao Za Zhi. 2023 Jul;48(13):3650-3663. doi: 10.19540/j.cnki.cjcmm.20230418.501.
This study aimed to systematically evaluate the efficacy and safety of different Chinese patent medicines in the treatment of idiopathic membranous nephropathy. The relevant randomized controlled trial(RCT) was retrieved from PubMed, EMbase, Cochrane Library, CNKI, SinoMed, Wanfang, and VIP with the time interval from database inception to December 2022. The Cochrane risk of bias assessment tool was employed to evaluate the quality of the included RCT, and Stata 15.0 and GEMTC to perform the Bayesian network Meta-analysis. Finally, 51 RCTs were included, involving 9 Chinese patent medicines and 3 591 patients. The results of network Meta-analysis showed that in terms of the total effective rate and the increase in plasma albumin, the top three interventions were Zhengqing Fengtongning Sustained Release Tablets + conventional western medicine, Bailing Capsules + conventional western medicine, and Tripterygium Glycosides Tablets + conventional western medicine. In terms of reducing 24-hour urine total protein, the top three interventions were Zhengqing Fengtongning Sustained Release Tablets + conventional western medicine, Shenfukang Capsules +conventional western medicine, and Huangkui Capsules + conventional western medicine. In terms of reducing serum creatinine, the top three interventions were Shenfukang Capsules + conventional western medicine, Bailing Capsules + conventional western medicine, and Zhengqing Fengtongning Sustained Release Tablets + conventional western medicine. In terms of safety, Chinese patent medicines combined with conventional western medicine had fewer adverse reactions than the control group. The results suggest that Chinese patent medicines combined with conventional western medicine can improve the therapeutic effect on idiopathic membranous nephropathy, and differentiated medications can be adopted according to the specific symptoms of patients in clinical treatment. Further validation needs to be carried out in the future with multi-center, large-sample, and high-quality RCT.
本研究旨在系统评价不同中成药治疗特发性膜性肾病的疗效和安全性。从PubMed、EMbase、Cochrane图书馆、中国知网、中国生物医学文献数据库、万方数据库和维普数据库检索从建库至2022年12月的相关随机对照试验(RCT)。采用Cochrane偏倚风险评估工具评价纳入RCT的质量,并用Stata 15.0和GEMTC进行贝叶斯网络Meta分析。最终纳入51项RCT,涉及9种中成药和3591例患者。网络Meta分析结果显示,在总有效率和血浆白蛋白升高方面,排名前三的干预措施为正清风痛宁缓释片+传统西药、百令胶囊+传统西药、雷公藤多苷片+传统西药。在降低24小时尿总蛋白方面,排名前三的干预措施为正清风痛宁缓释片+传统西药、参茯康胶囊+传统西药、黄葵胶囊+传统西药。在降低血清肌酐方面,排名前三的干预措施为参茯康胶囊+传统西药、百令胶囊+传统西药、正清风痛宁缓释片+传统西药。在安全性方面,中成药联合传统西药的不良反应少于对照组。结果表明,中成药联合传统西药可提高特发性膜性肾病的治疗效果,临床治疗中可根据患者具体症状采用辨证用药。未来还需进行多中心、大样本、高质量的RCT进一步验证。