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目的系统评价中医清热利湿法联合西药治疗IgA肾病的疗效。方法计算机检索CBM、CNKI、VIP、Pubmed等数据库,搜集中医清热利湿法联合西药(试验组)与单纯西药(对照组)治疗IgA肾病的随机对照试验,并手工检索相关会议论文,检索时限均从建库至2015年12月。由2位评价者根据纳入和排除标准独立筛选文献、提取资料并进行文献质量评价,然后采用Rev Man 5.3软件进行Meta分析。结果共纳入6个研究,Meta分析结果显示:中医清热利湿法联合西药在降低尿蛋白[MD=—0.35,95%CI(—0.46,—0.24),P<0.00001]、尿红细胞计数[MD=—3.94,95%CI(—5.32,—2.55),P<0.00001]方面优于单纯西药治疗,且治疗总有效率[RR=1.96,95%CI(1.62,2.25),P<0.00001]也高于单纯西药治疗。但在改善肾功能[MD=—12.34,95%CI(—38.13,13.44),P=0.35]方面,两组差异无统计学意义。结论当前证据显示,中医清热利湿法联合西药可减少IgA肾病患者蛋白尿、血尿,并能提高疗效,但受纳入研究的数量及质量所限,上述结论尚需更多高质量的相关研究加以验证。
Objective To systematically evaluate the curative effect of heat-clearing and damp-wet method combined with western medicine on IgA nephropathy. Methods The databases of CBM, CNKI, VIP and Pubmed were searched by computer, and randomized controlled trials were conducted to collect Chinese medicine clearing heat and dampness combined with Western medicine (experimental group) and Western medicine alone (control group) for IgA nephropathy. From building to December 2015. Two reviewers independently screened the literature based on the inclusion and exclusion criteria, extracted data and evaluated the quality of the literature, and then performed a meta-analysis using Rev Man 5.3 software. Results A total of six studies were included in the study. The results of Meta-analysis showed that the combination of Chinese medicine, heat-clearing and damp-wetting method and Western medicine in reducing urinary protein [MD = -0.35,95% CI -0.46, -0.24, P 0.00001] = -3.94, 95% CI (-5.32, -2.55), P <0.00001], and the total effective rate of treatment was significantly higher than that of western medicine alone [RR = 1.96,95% CI (1.62,2.25), P <0.00001] Higher than Western medicine alone. However, there was no significant difference between the two groups in improving renal function [MD = -12.34, 95% CI (-38.13, 13.44), P = 0.35]. Conclusions The current evidence shows that the combination of Chinese medicine, heat-clearing and dampness method and western medicine can reduce proteinuria and hematuria in patients with IgA nephropathy and can improve the curative effect. However, due to the limited quantity and quality of the included studies, the above conclusion still needs more high-quality relevant research verification.