Evaluation of tripterygium glycosides combined with α- ketoacid in the treatment of chronic kidney disease
雷公藤多苷联合α-酮酸治疗慢性肾脏病的Meta分析

摘要

目的 探讨雷公藤多苷（TGs）联合复方α-酮酸制剂治疗慢性肾脏病的疗效。方法 通过计算机与手工检索中文及外文数据库，查找有关雷公藤多苷联合复α-酮酸片治疗慢性肾脏病的随机对照和半随机对照试验，制定文献纳入及排除标准，按Cochrane系统评价员手册标准对纳入的文献进行质量评价，应用RevMan 5.4软件进行Meta分析。结果 共纳入9个对照试验，1415例慢性肾脏病患者，Meta分析结果显示：（1）联合组在降低24h尿蛋白、血清肌酐（SCr）、血尿素氮（BUN）、胱抑素C（CysC）的疗效优于对照组（P<0.01）；（2）联合组在肾小球滤过率（GFR）的疗效高于对照组（P<0.01）；（3）对炎症因子水平的影响，联合组在降低C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）的疗效优于对照组（P<0.01）；（4）对氧化应激的影响，联合组在降低丙二醛（MDA），提高超氧化物歧化酶（SOD）水平的疗效优于对照组（P<0.01）；（5）联合组的整体有效率高于对照组（P<0.01）。结论 雷公藤多苷联合复方α-酮酸制剂治疗慢性肾脏病患者优于单独应用雷公藤多苷，在临床上具有良好的应用前景。但由于纳入研究数量限制，仍需要更多高质量的随机对照试验加以证实。

Abstract

Objective To investigate the efficacy of Tripterygium glycoside (TGs) combined with compound α- ketoacid preparation in the treatment of chronic kidney disease.
Methods the database of Chinese and foreign languages was searched by computer and manual, and the random and semi-randomized controlled trials of Tripterygium glycoside combined with compound α-ketoacid tablets in the treatment of chronic kidney disease were found. According to the Cochrane system evaluator manual standard, the quality of the included literature was evaluated and the RevMan 5.4 software was used for Meta analysis.
Results There were 9 control trials and 1415 patients with chronic kidney disease. The results of Meta analysis showed that:(1) the combined group had better effect h reducing 24 urine protein and Serum Creatinine (SCr), Blood Urea Nitrogen (BUN), Cystatin C (CysC) than the control group (P<0.01); The efficacy of the combined group in elevated Glomerular Filtration Rate（GFR）was higher than that of the control group (P<0.01); (3) Effects on levels of inflammatory factors, The efficacy of the combined group in reducing C-reactive protein (CRP), Tumor Necrosis Factor-α (TNF-α) was better than that of the control group (P< 0.01); (4) Effects on oxidative stress, Combined group reduced Malondialdehyde (MDA), The effect of improving the Superoxide Dismutase (SOD) level was better than that of the control group (P<0.01); (5) The overall effective rate in the combined group was higher than the control group (P<0.01).
Conclusion   Tripterygium glycoside combined with compound α-ketonic acid preparation is superior to Tripterygium glycoside alone in the treatment of chronic kidney disease. However, due to the low quality of the included studies, high-quality randomized controlled trials are still needed to confirm.