Meta Analysis Of Kidney Nourishing Therapy Combined With Western Medicine In The Treatment Of Aplastic Anemia

Objective: To evaluate the clinical efficacy and safety of kidney tonifying therapy combined with western medicine in the treatment of aplastic anemia.Methods: with "aplastic anemia","Sui Lao","Bu Shen","Yi Shen","traditional Chinese medicine","integration of Chinese and Western medicine","western medicine","androgen","cyclosporine","tonifying kidney","Chinese medicine","Chinese traditional medicine","Chinese traditional medicine","Chinese and Western medicine treatment","western" Medicine,androgen and cycloporine are the search terms,which will be searched in CNKI,Wanfang,CBM,VIP and Pub Med databases until February 2020 A randomized controlled clinical trial of kidney tonifying Chinese medicine combined with western medicine in the treatment of AA was published Wednesday in Chinese and English.According to the inclusion criteria and exclusion criteria,two researchers collected qualified literature and analyzed it with Revman 5.3 softwareResults: 31[29-59]randomized controlled trials were included,with a total of 2126 cases.],PLT [WMD = 16.19,95% CI(8.09,24.28),Z= 3.92(P < 0.0001)] was superior to the control group;the experimental group was superior to the control group in increasing the number of cases with active or obviously active bone marrow [RR= 1.59,95% CI(1.27,1.99),z = 4.06(P < 0.0001)],but the experimental group was superior to the control group in reducing the number of cases with decreased or extremely decreased bone marrow [RR = 0.72,95% CI(0.49,1.05),There was no significant difference in Z = 1.69(P = 0.09)compared with the control group;the experimental group was better than the control group in reducing TCM symptom score [WMD =-6.32,95% CI(-8.70,-3.95),z = 10.57(P < 0.00001)];the experimental group was better than the control group in improving TCM symptom efficacy [RR = 1.28,95% CI(1.17,1.41),z = 5.10(P < 0.00001)],TCM symptom efficacy clinical recovery [RR = 2.59,95% CI(1.58,4.25),(0.20,0.61),Z = 3.76(P= 0.0002),gastrointestinal response [RR = 0.37,95% CI(0.19,0.75),z = 2.76(P = 0.006)] were superior to the control group.The most frequently used traditional Chinese medicine was 26 times in mature land,24 times in dodder,24 times in Angelica,23 times in Astragalus,19 times in Eclipta,18 times in Ligustrum lucidum and18 times in Psoralea.18 articles reported the adverse reactions after treatment,and 2 articles showed no adverse reactions in the experimental group and the control group.The adverse reactions reported were liver function abnormality(transaminase elevation),gastrointestinal reaction(anorexia,nausea,diarrhea,etc.),gingival hyperplasia,acne,hirsutism,renal function abnormality,hand tremor,hoarseness,numbness,hypertension,convulsion,blood sugar abnormality,ECG abnormality,edema of both lower limbs.The main adverse reactions were liver dysfunction(transaminase elevation),gastrointestinal reaction(anorexia,nausea,diarrhea,etc.),gingival hyperplasia,acne and hirsutism.Conclusion: kidney nourishing therapy combined with western medicine is superior to western medicine in improving the total effective rate,basic cure,WBC,HGB,PLT,the number of cases with active or obviously active marrow,the total effective effect of TCM symptoms,and the clinical cure of TCM symptoms;kidney nourishing therapy combined with Western Medicine is superior to western medicine alone in reducing the integral of TCM symptoms,but it is superior to western medicine alone in reducing bone marrow bone There was no statistical difference in the number of cases of hypomyelia or extreme hypomyelia between the two groups;there was no statistical difference in the safety between the two groups,but the kidney tonifying method combined with western medicine group was superior to the western medicine group in reducing liver function damage,gingival hyperplasia,acne and gastrointestinal response.The most frequently used traditional Chinese medicines are prepared land,dodder,angelica,astragalus,Eclipta(Eclipta),Ligustrum lucidum and Psoralea.The main adverse reactions were liver dysfunction(transaminase elevation),gastrointestinal reaction(anorexia,nausea,diarrhea,etc.),gingival hyperplasia,acne and hirsutism.The quality of the literature included in this analysis is generally low and the heterogeneity is large,which may affect the accuracy of this analysis.Therefore,more large samples and high-quality RCT experiments are needed.