Meta-analysis Of Prevention And Treatment Of Contrast-enhanced Kidney Disease With Integrated Chinese And Western Medicine

Objective:This assay evaluates the clinical efficacy for prevention of contrast induced nephropathy,to provide evidence for clinical treatments.Methods:According to the Cochrane evaluation system(1.step problem;2.identification and selection of original research reports;3.strict evaluation of original research reports;4.data collection;5.analysis and reporting of results;6.interpretation of the results;7.to improve and update the original evaluation)formulated the inclusion and exclusion criteria.Trough searching Chinese journal full text database,Chinese science and Technology Journal full text Database,Wanfang database,Chongqing VIP database,Chinese Biomedical Literature Database Collection,China Science Citation Database,we collect RCTs from 2008 to 2016 about traditional Chinese medicine combined with Western Medicine(treatment group)than the other methods(the control group)for prevention of contrast induced nephropathy.The experiment consists of two professionals according to the inclusion and exclusion criteria were evaluating the quality of extracted data then cross checked,using Rev Man 5.3 statistical software for Meta analysis.Evaluation index:incidence,serum creatinine(Scr),etc.Results:We totally concluded 23 RCTs,about 2738 patients,of which 1375 cases were in the treatment group with combination of TCM and Western medicine,and 1363 cases were in the control group.Compared with the control group,(1)23 articles compared the incidence rate between combined TCM and Western medicine with Western medicine of prevention of contrast induced nephropathy:there was no statistical heterogeneity among the studies(P=1.00,I2=0%),and carries on the analysis using the fixed effect model.The results of Meta analysis showed that:[RR=0.25,95%CI(0.19,0.34),P<0.00001],the clinical efficacy of the two groups was statistically significant,suggesting that the incidence of CIN was significantly lower than that the control group,and the incidence rate of the disease could be reduced 74%.(2)23 studies reported the mean serum creatinine values of 1-7d after angiography.Select the highest value to do research.There was heterogeneity(P<0.00001,I2=78%),using random effects model.Meta analysis showed that [MD=-11.24,95%CI(-12.76,-9.72),P < 0.00001],the difference was statistically significant.The results showed that the average serum creatinine in the treatment group was lower than that in the control group.15 studies reported the application of drug adverse reactions in the control group and the treatment group occurred.There was no significant heterogeneity between the studies(P=1.00,I2=0%),using the fixed effect model..Meta analysis showed that [OR=0.22,95%CI(0.10,0.49),P=0.0002],the difference was statistically significant.The results indicated that the combination of Chinese and Western medicine in the prevention of contrast induced nephropathy had less adverse reactions than the western medicine group.Conclusion:The current data shows that the clinical efficacy of traditional Chinese medicine and Western medicine in the prevention of contrast induced nephropathy and the improvement of serum creatinine clearance rate are better than other drugs,The incidence of adverse reactions was less than that of simple western medicine group.However,the limitations of the inclusion of research literature,more high-quality randomized controlled trials are needed to confirm.