摘要
目的评价在糖皮质激素基础上使用雷公藤多苷或环磷酰胺治疗肾病综合征的有效性和安全性。方法检索电子资料库包括Cochrane图书馆、PUBMED、科学引文索引（SCI）、中国知网（CNKI）、维普、万方数据库，收集比较雷公藤多苷与环磷酰胺治疗肾病综合征的随机对照试验，对纳入研究的方法学质量进行评价。选择临床总有效率及完全缓解率作为疗效指标，治疗期发生胃肠道反应、肝功能受损、白细胞减少等不良反应的患者比例作为安全性评价指标，提取数据并采用Co—ehrane协作网推荐的RevMan4．2．10软件进行统计分析。结果共检索到符合纳入标准的随机对照试验7篇（共379例肾病综合征患者）。对疗效指标的荟萃（Meta）分析结果显示，雷公藤多苷治疗。肾病综合征的总有效率优于环磷酰胺，而两者治疗肾病综合征的完全缓解率无统计学差异，两者治疗难治性肾病综合的临床疗效无统计学差异。安全性评价各项指标的Meta分析提示，雷公藤多苷优于环磷酰胺。结论雷公藤多苷在（难治性）肾病综合征患者的疗效与目前常规的环磷酰胺大致相当，但在药物安全性方面优于后者。
Objective To evaluate the efficacy and safety of Triptergium wilfordii Hook F （TwHF） or CTX in the treatment of refractory nephrotic syndrome on the basis of glucocorticoid. Methods We searched Cochrane Collaboration Database, PUBMED, SCI, CNKI, VIP and Wanfang databases for RCTs that compare TwHF and CTX in the treatment of refractory nephrotic syndrome, and the methodology of enrolled studies was evaluated. The total effective rate and complete response rate were used to evaluate the curative effects. Gastrointestinal tract reaction, hypohepatia, leukopenia and so on were chosen as safety evaluation indexes. The data were extracted and statistically analyzed by using 4. 2. 10 software RevMan recommended by Cochrane network. Results There were 7 articles which were accorded with the standard randomized controlled trial （379 cases）. Meta analysis showed the total effective rate of TwHF was higher than that of CTX in the treatment of nephrotic syndrome, but there was no significant difference in complete response rate between them. Moreover, there was no significant difference in clinical curative effects of TwHF vs CTX in the treatment of persistent ne- phrotic syndrome. Meta analysis on safety evaluation index showed that TwHF was superior to CTX. Conclusions TwHF and CTX is almost comparable, but the former has lower ratio of adverse events than the later in the treatment of refractory nephrotic syndrome.
出处
《临床肾脏病杂志》
2011年第11期522-524,共3页
Journal Of Clinical Nephrology
关键词
雷公藤
环磷酰胺
肾病综合征
META分析
Triptergium wilfordii
Cyclophosphamide
Nephrotic syndrome
Meta-analysis
