Lin Aitao, Zhang Zhiying, Liu Xiaoyu, Wu Jinyu
Guangxi University of Traditional Chinese Medicine, Nanning, Guangxi, 530001, China.
Department of Rheumatology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, Guangxi, 530023, China.
Heliyon. 2023 Jul 28;9(8):e18711. doi: 10.1016/j.heliyon.2023.e18711. eCollection 2023 Aug.
To analyze the efficacy and safety of proprietary Chinese medicines for the treatment of Lupus Nephritis (LN) based on the reticulated meta analysis. The study aim to provide evidence-based evidence for the clinical treatment of LN.
The studies related to the randomized controlled studies (RCTs) on the treatment of LN with oral proprietary Chinese medicines were obtained from China National Knowledge Infrastructure (CNKI), Database for Chinese Technical Periodicals (VIP), SinoMed, Wanfang, PubMed, Web of Science, Embase and Cochrane Library databases since its inception-August 2022. Cochrane tools were used for risk bias assessment, Stata 13.0 and ADDIS 1.16.5 software were used for net evidence analysis.Results.1) 41 RCTs with 3124 L N patients were included, involving 9 types of proprietary Chinese medicines.2) The meta-analysis showed that in terms of efficacy, the top 3 Chinese patent medicine interventions were Xin Gan Bao Capsule (XGB) +western medicines (WM), Huang Kui Capsule (HK) + WM, Kun Xian Capsule (KX) + WM; in terms of reducing adverse event rate, the top 3 Chinese patent medicine interventions were Yi Shen Hua Shi Granules (YSHS) + WM, Jin Shui Bao Capsule (JSB) + WM, HK + WM; in terms of reducing 24 h urine protein, the top 3 Chinese patent medicine interventions were XGB + WM, YSHS + WM, Bai Ling Capsule (BL) + WM; in terms of reducing blood creatinine (Cr), the top 3 Chinese patent medicine interventions were Yi Shen Granules (YS) + WM, JSB + WM, KX + WM; in terms of reducing urea nitrogen (BUN), the top 3 Chinese patent medicine interventions were Shen Kang Capsule (SK) + WM, HK + WM, JSB + WM; in terms of reducing systemic lupus erythematosus disease activity index (SLEDAI) scores, the top 3 Chinese patent medicine interventions were JSB + WM, BL + WM, YSHS + WM; in terms of improving complement C3, the top 3 Chinese patent medicine interventions were HK + WM, XGB + WM, BL + WM; in terms of improving complement C4, the top 3 Chinese patent medicine interventions were KX + WM, YSHS + WM, BL + WM.
Xin Gan Bao Capsule has a good efficacy in improving efficiency and the level of complement C3, lowering 24 h urine protein. Jin Shui Bao Capsule and Huang Kui Capsule have a good efficacy in treating LN. However, more multicentre, large sample and high quality RCTs are needed for validation the results.
基于网状Meta分析探讨中成药治疗狼疮性肾炎（LN）的疗效及安全性，旨在为LN的临床治疗提供循证依据。
检索中国知网（CNKI）、维普中文科技期刊数据库（VIP）、中国生物医学文献数据库（SinoMed）、万方数据库、PubMed、Web of Science、Embase及Cochrane图书馆数据库中自建库至2022年8月有关口服中成药治疗LN的随机对照试验（RCT）。采用Cochrane工具进行偏倚风险评估，运用Stata 13.0及ADDIS 1.16.5软件进行网状证据分析。结果：1）纳入41项RCT，共3124例LN患者，涉及9种中成药。2）Meta分析显示，疗效方面，排名前三的中成药干预措施为心肝宝胶囊（XGB）+西药（WM）、黄葵胶囊（HK）+WM、昆仙胶囊（KX）+WM；降低不良事件发生率方面，排名前三的中成药干预措施为益肾化湿颗粒（YSHS）+WM、金水宝胶囊（JSB）+WM、HK+WM；降低24小时尿蛋白方面，排名前三的中成药干预措施为XGB+WM、YSHS+WM、百令胶囊（BL）+WM；降低血肌酐（Cr）方面，排名前三的中成药干预措施为益肾颗粒（YS）+WM、JSB+WM、KX+WM；降低尿素氮（BUN）方面，排名前三的中成药干预措施为肾康胶囊（SK）+WM、HK+WM、JSB+WM；降低系统性红斑狼疮疾病活动指数（SLEDAI）评分方面，排名前三的中成药干预措施为JSB+WM、BL+WM、YSHS+WM；改善补体C3方面，排名前三的中成药干预措施为HK+WM、XGB+WM、BL+WM；改善补体C4方面，排名前三的中成药干预措施为KX+WM、YSHS+WM、BL+WM。
心肝宝胶囊在提高有效率、改善补体C3水平、降低24小时尿蛋白方面疗效较好。金水宝胶囊和黄葵胶囊治疗LN疗效较好。但需更多多中心、大样本、高质量的RCT验证该结果。
