A Systematic Review Of Tripterygium Wilfordii Hook F In The Treatment Of IgA Nephropathy

Objective:To assess the effectiveness and safety of Tripterygium wilfordii Hook F in the treatment of IgA nephropathy.Methods:Systematic retrieving randomized controlled trials about the treating IgA nephropathy with Tripterygium wilfordii Hook F in CENTRAL?EMBASE?PUBMED?CNKI?VIP?WanFang?CBM database between established and December 2016.Screening and extracting data independently by two investigator according to the inclusion and exclusion criteria,then through the summary and discussion,The final documents have to be included in.The risk of bias and quality of evidences were assessed by the rule of Cochrane systematic reviews.Finally the clinical outcomes including complete remission rate,total effective rate,24-hour urinary protein,serum albumin,serum creatinine,adverse reactions were meta analyzed by RevMan.Results:A total of 16 randomized controlled trials were included to the difference of the control group of drugs,the 16 RCTs were divided into three groups,including ACEI/ARB group,GCS group and MMF group,in which ACEI/ARB group includes using tripterygium wilfordii(TW)only and TW+ACEI/ARB.The results of meta analysis according to each group showed:(1)Compared with the ACEI/ARB group,the group of using tripterygium wilfordii(TW)only and TW+ACEI/ARB both have a better outcome than the ACEI/ARB group,in the CR(complete remission),TR(total remission),decrease of 24-hour urinary protein,and the rise of serum albumin(P?0.05),In the aspect of loweringserum creatinine and the incidence of adverse reactions,the group of using TW only and the control group with nobetween-group differences(P?0.05),the TW+ACEI/ARB group has significant differences compared with the control group in lowering serum creatinine(P?0.05),but has higher incidence of adverse reactions than the control group(P?0.05);(2)Compared with the GCS group,TW group has a better outcome than the control group in TR(P?0.05),but it has no differences in CR than the control group(P?0.05),then the TW+low-dose GCS group has a better outcome than the full-dose GCS group in decreasing of24-hour urinary proteinand lowering incidence of adverse reactions(P?0.05),Finally the TW+low-dose GCS group has a better outcome than the low-dose GCS group(P?0.05)and has no differences with the full-dose GCS group in lowering serum creatinine(P?0.05);(3)Compared with the MMF group,the TW+MMF group has a better outcome than the control group in the TR,decrease of 24-hour urinary protein,and the rise of serum albumin(P?0.05);but it has no differences with the control group in the CR,lowering serum creatinine and the incidence of adverse reactions(P?0.05).Conclusion:TW has exact curative effect in the treatment of IgA nephropathy,and has certain advantages in the aspect of CR,TR,decrease of24-hour urinary protein,and the rise of serum albumin.The study shows the side effects rate of TW is similar to the control group,and side effects can be alleviated after reduction or withdrawal of TW.