Meta-analysis of the Efficacy and Safety of Chinese Medicine in Treating Refracto-ry Nephrotic Syndrome in Children and Analysis of Traditional Chinese Medicine Syndrome Types
Objective To systematically evaluate the efficacy and safety of Chinese Medicine in treating refractory nephrotic syndrome(RNS)among children,and to statistically analyze the traditional Chinese medicine(TCM)syndrome types included in the study.Methods CNKI,Wanfang Data,VIP,SinoMed,PubMed,Cochrane Library,and Web of Sci-ence were searched from the inception of the databases to March 1,2023.Literature involving randomized controlled trials(RCTs)on integrated Chinese and western medicine treatment for children RNS was screened according to preset inclusion and exclusion criteria,and data were extracted.Cochrane risk of bias was used to assess the methodological quality of the literature.Outcome indexes were meta-analyzed using Revman 5.3,and the quality of evidence was evaluated by the GRADE system,along with frequency statistics of TCM syndrome types included in the literature.Results A total of 27 articles were included,comprising 1 876 patients,with 967 in the integrated Chinese and western medicine group and 909 in the single western medicine group.Meta-analysis indicated that,compared with single western medicine,integrated treatment for children RNS improved the total clinical effective rate(RR=1.21,95％CI[1.16,1.26],P＜0.000 01).The integrat-ed treatment also had certain advantages in improving 24 h urinary protein quantification(MD=-0.82,95％CI[-1.10,-0.54],P＜0.000 01),albumin(MD=6.51,95％CI[4.68,8.34],P＜0.000 01),total cholesterol(MD=-1.39,95％CI[-1.81,-0.98],P＜0.000 01),triglycerides(MD=-0.48,95％CI[-0.72,-0.23],P=0.000 1),urea nitrogen(MD=-0.73,95％CI[-0.93,-0.53],P＜0.000 01),and blood creatinine(MD=-26.15,95％CI[-40.01,-12.29],P=0.000 2).Additionally,it reduced recurrence rate(RR=0.37,95％CI[0.28,0.50],P＜0.000 01)and adverse reactions(RR=0.42,95％CI[0.32,0.54],P＜0.000 01).The TCM syndrome types most frequently observed in the included children were spleen and kidney yang deficiency(31.4％),qi and yin deficiency(14.3％),liver and kidney yin deficiency(11.4％),lung and spleen qi deficiency(8.6％),and spleen deficiency with dampness stagnation(8.6％).Conclusion Based on the available evidence,integrated Chinese and western medicine in treating children RNS has a no-table effect on improving clinical symptoms and demonstrates high safety.The pathogenesis characteristics of children RNS,reflected by the studied TCM syndrome types,suggest deficiency-excess in complexity and deficiency in nature and excess in superficiality.These conclusions,however,need further confirmation through additional large-scale,high-quality re-search.
Chinese medicineChildrenRefractory nephrotic syndromeTraditional Chinese medicine syndrome typesMeta-analysis
万方数据
维普
