【摘要】：目的評價中西醫(yī)結(jié)合治療小兒原發(fā)性腎病綜合征的療效。方法計算機檢索2000～2010年P(guān)ubMed、Medline、中國生物醫(yī)學(xué)文獻光盤數(shù)據(jù)庫(CBM disc)、中文期刊網(wǎng)全文數(shù)據(jù)庫(CNKI)、中國優(yōu)秀博碩士學(xué)位論文全文數(shù)據(jù)庫(CDMD)、萬方數(shù)據(jù)庫、Cochrane Library(2010,第2期);并手工檢索納入文獻的參考文獻、相關(guān)學(xué)位論文和會議論文集。由2名研究人員分別獨立檢索、篩選文獻,并獨立對納入文獻依據(jù)Jadad量表進行質(zhì)量評價和數(shù)據(jù)提取。用Rev-Man 5.1.5軟件進行Meta分析。結(jié)果①共納入17篇文獻,980例患者,其中治療組535例,對照組445例。除1篇Jadad評分3分的文獻外,其余均為1～2分的低質(zhì)量文獻。各研究均明確指出基線均衡,具有可比性。有2篇文獻提到使用隨機數(shù)字表,其余文獻只提到隨機分組,但并未詳細(xì)描述隨機序列的產(chǎn)生方法。所有納入文獻均未對隨機分配方案進行隱藏,均未使用盲法;②Meta分析結(jié)果顯示:中西醫(yī)結(jié)合療法治療小兒原發(fā)性腎病綜合征在減少24h尿蛋白定量(UPT)(SMD-0.74,95%CI[-1.12,-0.37])、升高血漿白蛋白(ALB)(SMD 0.64,95%CI[0.38,0.90])、降低血脂(TC:MD-1.24,95%CI[-1.80,-0.69];TG:MD-0.41,95%CI[-0.66,-0.17])、減少復(fù)發(fā)率(RR 0.39,95%CI[0.30,0.52])和縮短水腫消退時間(MD-4.30,95%CI[-5.19,-3.41])方面優(yōu)于常規(guī)激素或激素加免疫抑制劑治療,且差異有統(tǒng)計學(xué)意義。結(jié)論在激素或激素加免疫抑制劑常規(guī)治療的基礎(chǔ)上加用中醫(yī)藥治療,對小兒原發(fā)性腎病綜合征患者24hUPT、血脂(TC、TG)、復(fù)發(fā)率的降低,水腫消退時間的縮短及升高ALB方面的作用優(yōu)于常規(guī)治療,且敏感性分析未能從實質(zhì)上改變Meta分析的結(jié)果,但納入該Meta分析的文獻方法學(xué)質(zhì)量較低,而且可能存在發(fā)表性偏倚,因此,尚有待于設(shè)計嚴(yán)密規(guī)范的大樣本、多中心、隨機雙盲對照研究進一步證實。
[Abstract]:Objective to evaluate the effect of integrated traditional Chinese and western medicine on children with primary nephrotic syndrome. Methods computer search was conducted on PubMedine Medline from 2000 to 2010, full text Database of Chinese Biomedical Literature disc), (CNKI), full text Database of excellent Master's degree papers of China (CDMD), Cochrane Library of Wanfang (2010, 2nd issue), and manual examination. References included in the literature, Related dissertations and conference papers. The literature was searched and screened by two researchers, and the quality evaluation and data extraction based on Jadad scale were carried out independently. Meta-analysis was carried out with Rev-Man 5.1.5 software. Results 1 A total of 980 patients were included in 17 literatures, including 535 cases in the treatment group and 445 cases in the control group. Except for one piece of literature with Jadad score of 3, the rest were all of low quality literature with score of 1 ~ 2. Each study clearly points out that the baseline is balanced and comparable. There are two references to the use of random number tables and the rest to random grouping, but the method of generating random sequences is not described in detail. All the literature included did not hide the random distribution scheme, and no blind method was used. 鈶eta鍒嗘瀽緇撴灉鏄劇ず:涓タ鍖葷粨鍚堢枟娉曟不鐤楀皬鍎垮師鍙戞，

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