Therapeutic Effectiveness Evaluation Study On Traditional Chinese Medicine Of Latent Glomerulonephritis And The Systematic Review

Object iveUsing the method of the observational and EBM to evaluate the efficiency and safety of traditional Chinese medicine therapy for latent glomerulonephritis. And then to provide TCM treatment of latent glomerulonephritis based on evidence.MethodsIn this retrospective and prospective study,46LGN patients who were eligible for the inclusion criteria were treated by LGN Chinese medicine diagnosis and treatment scheme for3months, the clinical efficacy evalulated by the changes of symptom scores, red blood cell count in urine before and after treatment; We searched for studies according to the search stategy of The Cochrane Collaboration Group. The following databases were searched:Pubmed, Embase, Central, Chinese Biological Medicine database (CBM), China National Knowledge Infrastructure (CNKI) and the VIP database (VIP), Manual retrieval conference material and literatures which were not published. Two authors independently assessed trial qualities and extracted Data from these Randomized Controlled Trails, then imported them into the Meta-analysis by Rev. Man5.1or did the descriptive analysis those who could not do the Meta-analysis.Results①The TCM pathogenesis of LGN was attributive to primary deficiency and secondary excess.In the respect of the primary deficiency syndrome, the most common type was spleen and kidney Qi deficiency, account for47%, followed by both Qi and Yin deficiency (26%), liver and kidney Yin deficiency (20%), spleen and kidney Yang deficiency(7%); In the respect of the secondary excess syndrome, the most common type was dampness and heat syndrome (34%), the secondary were dampness and heat accompanied by blood stasis(22%), pathogenic wind and hot syndrome (22%);②The changes of symptom scores:46LGN patients with effective29cases and ineffective17cases after TCM treatment, the effective rate of improved symptom was63.04%, and the ineffective rate of improved symptom was36.96%. Compared with before treatment, the changes of symptom scores was decreased after treatment, there is statistical differences (P<0.05);③The evaluation of clinical efficacy:In these46patients, there was3cases of clinical control (6.52%),15cases of apparent effective(32.61%) and21cases of effective. The total effective rate was84.78%, the number of derormed red blood cells and red blood cells in urine were all decreased.④Six trials involving455patients were included. The results of Meta-analysis indicated that TCM treatment on LGN have a better effect in respects of clinical comprehensive efficacy, reducing red blood cells in urine and serum IgA compared with Western-based treatment, there is no statistical differences in respects of decreasing the urine protein level, and serum IgG, serum IgM, serum C3. Owing to small simple and inferior quality of the included studies,it is still not sure that TCM treatment has a definite efficacy on LGN.ConclusionThrough the study of46LGN patients who treated by TCM therapy, Traditional Chinese medicine can improve clinical symptom and signs, decrease red blood cells in urine,which will lay the foundation for a massive clinical research in future. The study drawn that TCM therapy can improve the clinical efficacy for latent glomerulonephritis to some extent. Because of the low qualities of researches,the small sample sized researches and not long enough therapy and follow-up time, the evidence is very low. It is caution to interpret these results. The exact effect need to design a strict multi-center, large sample randomized, double-blind, placebo-controlled trial futher confirmed.