Astragali For Chronic Glomerulus Disease In Adults: A Systematic Review

Objectives: (1)To assess the efficacy of Astragali for adult with chronic primary glomerulus disease.(2)Whether astragali can help to improve the effectiveness of prednisone and immunosoppressor for nephrotic syndrome. (3)To assess the difference of effectiveness between single injection and decoction of compound herbs ingredients of Astragali for nephrotic syndrome.Methods Search were applied to the following electronic databases: Medline; Embase Database; Cochrane Library; CBMdisc; CEBM/CCD. Meanwhile, handearch was applied in 10 kinds of Journal of Chinese traditional medicine and relevant to nephrology and Urology to date until September 2001. Randomised control trials with at least one months for therapy and follow-up should been used. Data were extracted independently by two reviewers. The methodological quality of trails was assessed by the Jadad-scale. Intention-to treat analyses were performed with RevMan4.1.Results: At first 335 papers were searched. There were 179 papers for Astragali to treat chronic glomerulud disease. There were 22 PCTs accord to the criterion. It is included 8 RCTs of chronic-glbmerulonephritis which have 275 patients and 14 RCTs of nephrotic which have 524 patients. Meta-analysis of Astragali versus control-group for chronic glomerulonephritis and nephrotic syndrome have proved that the Chinese medicinal herb can decrease 24h proteinuria and total cholesterol and Scr and increase the total effectrate of therapy and ALB. There are no difference the between single injection and decoction of compound herbs ingredients, "funnel plot" show imsymmetry which relate to less quality in methology and samall in sample . Review's conclusion: Some Astragali (a traditional Chinese medicinal herb) may work in chronic glomerulonephritis and nephrotic syndrome. Chinese traditional medicine with Western medicine to treat chronic glomerulud disease should improve the effection of treatment. As the studies of these RCTs belong to lower qualities and had not time enough in treatment, the strength of evidence is lower. So big sample RCTs and multiply-center should be used to assess the effect of therapy in adult with chronic glomerulus disease...