中西医结合治疗小儿原发性肾病综合征的系统评价与Meta分析(1)
摘要 目的：系统评价中西医结合治疗小儿原发性肾病综合征的疗效。方法：计算机检索2006年至2016年CNKI、万方数据库、维普数据库、Sinomed、Pubmed数据库，手工检索纳入文献的参考文献及2016年下半年10种相关中文期刊，查找以中西医结合方式治疗小儿原发性肾病综合征的随机对照试验(RCT)，按纳入选标准和排除标准筛选文献、提取资料和评价纳入研究的方法学质量后，采用RevMan5.3软件进行Meta分析。结果：1)共纳入19篇文献，1 466例患者，其中治疗组754例，对照组712例，各研究均明确指出基线均衡，具有可比性。2)Meta分析结果显示：中西医结合治疗小儿原发性肾病综合征在提高临床疗效(RR=1.27，95%CI[1.20，1.35])、减少24 h尿蛋白定量(UTP)(SMD=-0.71，95%CI[-0.84，-0.59])、升高血浆白蛋白(ALB)(SMD=0.90，95%CI[0.70，1.10])、降低血脂TC：MD=-1.49，95%CI[-1.96，-1.01]；TG：SMD=-0.71，95%CI[-1.01，-0.41])、减少不良反应(OR=0.16，95%CI[0.10，0.27])及降低复发率(RR=0.49，95%CI[0.37，0.64])等方面明显优于单纯西药治疗，其差异具有统计学意义。结论：当前证据表明，以中西医结合治疗小儿原发性肾病综合征较单纯西药治疗具有明显优势，但受纳入研究的数量和质量上的限制，以上结论仍需开展更多高质量的研究予以验证。
, 百拇医药
关键词 小儿；原发性肾病综合征；随机对照试验；系统评价；Meta分析
Abstract Objective：To systematically review the efficacy of the integrated Chinese and western medicine treatment for primary nephrotic syndrome in children. Methods：Papers on databases including CNKI (2006-2016)， VIP (2006-2016) WanFang (2006-2016)， Sinomed (2006-2016) and PubMed (2006-2016) were searched to identify the randomized controlled trials(RCTs) on integrated Chinese and western medicine treatment for primary nephrotic syndrome in children. According to the inclusion and exclusion criteria， the data of those papers were extracted， their quality were assessed. Then meta-analysis was performed using RevMan5.3 software. Results：A total of 19 papers involving 1466 patients were included (754 in the treatment group and 712 in the control group). Baseline data of the studies were comparable. The results of the meta-analysis indicated that integrated Chinese and western medicine therapy were superior to conventional glucocorticoid treatment in improving efficacy(RR=1.27，95%CI[1.20，1.35])， decreasing 24 h′s UTP(SMD=-0.71， 95%CI[-0.84，-0.59])， elevating(ALB) (SMD=0.90， 95%CI[0.70， 1.10])， increasing TC：MD=-1.49， 95%CI[-1.96，-1.01]；TG：SMD=-0.71，95%CI[-1.01，-0.41])， reducing adverse reactions(OR=0.16，95%[0.10，0.27]， and reducing relapse rate (RR=0.49，95%CI[0.37，0.64]). Conclusion：Meta-analysis results suggested that the efficacy of the integrated Chinese and western medicine treatment for primary nephrotic syndrome in children is better. Because of the limited quantity and quality of the included studies， the above conclusion still needs to be verified by conducting more high-quality studies.
Key Words Children； Primary nephrotic syndrome； Randomized controlled trials； Systematic review； Meta-analysis
中圖分类号：R2-031；R692文献标识码：Adoi：10.3969/j.issn.1673-7202.2017.06.060, 百拇医药(仉晓燕 李靖)
, 百拇医药
关键词 小儿；原发性肾病综合征；随机对照试验；系统评价；Meta分析
Abstract Objective：To systematically review the efficacy of the integrated Chinese and western medicine treatment for primary nephrotic syndrome in children. Methods：Papers on databases including CNKI (2006-2016)， VIP (2006-2016) WanFang (2006-2016)， Sinomed (2006-2016) and PubMed (2006-2016) were searched to identify the randomized controlled trials(RCTs) on integrated Chinese and western medicine treatment for primary nephrotic syndrome in children. According to the inclusion and exclusion criteria， the data of those papers were extracted， their quality were assessed. Then meta-analysis was performed using RevMan5.3 software. Results：A total of 19 papers involving 1466 patients were included (754 in the treatment group and 712 in the control group). Baseline data of the studies were comparable. The results of the meta-analysis indicated that integrated Chinese and western medicine therapy were superior to conventional glucocorticoid treatment in improving efficacy(RR=1.27，95%CI[1.20，1.35])， decreasing 24 h′s UTP(SMD=-0.71， 95%CI[-0.84，-0.59])， elevating(ALB) (SMD=0.90， 95%CI[0.70， 1.10])， increasing TC：MD=-1.49， 95%CI[-1.96，-1.01]；TG：SMD=-0.71，95%CI[-1.01，-0.41])， reducing adverse reactions(OR=0.16，95%[0.10，0.27]， and reducing relapse rate (RR=0.49，95%CI[0.37，0.64]). Conclusion：Meta-analysis results suggested that the efficacy of the integrated Chinese and western medicine treatment for primary nephrotic syndrome in children is better. Because of the limited quantity and quality of the included studies， the above conclusion still needs to be verified by conducting more high-quality studies.
Key Words Children； Primary nephrotic syndrome； Randomized controlled trials； Systematic review； Meta-analysis
中圖分类号：R2-031；R692文献标识码：Adoi：10.3969/j.issn.1673-7202.2017.06.060, 百拇医药(仉晓燕 李靖)
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