Meta-analysis Of Jianpilishibushenhuoxue Method In The Treatment Of Chronic Glomerulonephritis

Objective:To evaluate the clinical efficacy and safety of Jianpilishibushenhuoxue method in the treatment of chronic glomerulonephritis by literature collection and evidence-based medicine.Methods:By means of computer and manual retrieval,a comprehensive collection of Chinese biomedical Periodicals citation database(CBM disc),Chinese journal full-text database(CNKI),VIP information Chinese Science and Technology periodical Database(VIP),Wanfang Medical Network database and other medical literature database,January2003 to December 2018 clinical study literature on the treatment of chronic glomerulonephritis with Jianpilishibushenhuoxue method.To formulate certain inclusion and exclusion criteria,to carry out data extraction and risk bias assessment for eligible trials,and to use RevMan5.3 software,Stata12.0 software to carry out statistical analysis of the overall clinical efficacy after treatment,24-hour urine protein quantification,blood creatinine,blood urea nitrogen,etc.Descriptive analysis is intended for data that cannot be Meta-analyzed.The heterogeneity test of the inclusion study was carried out by using Q value statistic test and I~2 value statistic test.If the P>0.10,I~2?50%,suggesting the inclusion of statistical heterogeneity is small,the fixed effect model is used to analyze,if the P?0.10,I~2>50%,suggest that the study of statistical heterogeneity is large,according to possible heterogeneity factors for subgroup analysis or sensitivity analysis to eliminate heterogeneity,if heterogeneity still exists,but it is clinically homogeneous,and the stochastic effect model is used for analysis.The second classification variable adopts the MH method as the statistical method,the ratio ratio is the effect index,when the continuous variable is calculated,if the same intervention measure method and unit are the same,the mean difference is used,if the same intervention measure method,unit or dimension is different,the standardized mean difference is used,both of which are95%The reliability interval is studied to analyze the effect quantity of statistical analysis.Results:A total of 2,328 literatures were retrieved,and 16 literatures were finally included,a total of 1450 patients,including 750 cases in the observation group and 700 cases in the control group.Risk bias assessment of the inclusion study showed that the quality of the included studies was low and there was some bias.The results of Meta-analysis showed that:Jianpilishibushenhuoxue method combined basic western medicine in the treatment of CGN in the total clinical efficacy[OR=3.58,95%CI(2.67,4.81),P?0.00001],24h urine protein quantification[MD=-0.54,95%CI(-0.72,-0.37),P?0.00001],in blood creatinine[MD=-2.06,95%CI(-2.85,-1.26),P?0.00001],blood urea nitrogen[MD=-2.06,95%CI(-2.85,-1.26),P?0.00001]The difference was statistically significant due to the treatment of simple Western medicine,and the results of adverse reactions in the two groups showed no significant difference in adverse reactions between the group and the control group[OR=0.63,95%CI(0.34,1.15),P=0.13].After the sensitivity test,it was found that the results were better in robustness.The results showed that the total clinical efficacy,adverse reaction funnel diagram of the test group and the control group were symmetrical,the 24h urine protein quantification and the blood creatinine funnel map were generally symmetrical,suggesting that there was less possibility of publication bias,while the blood Urea nitrogen funnel chart showed no obvious symmetry and did not show a typical inverted funnel distribution,suggesting that there might be publication bias.Conclusion:The curative effect of Jianpilishibushenhuoxue method combined in the treatment of chronic glomerulonephritis is compared with that of simple Western medicine,which has the advantages of curative effect in improving clinical total efficiency,reducing 24h urine protein quantification,blood creatinine,blood urea nitrogen and so on,and there is no significant difference between the two groups of adverse drug reactions.However,due to the general quality of the literature,the small sample size,and the existence of a certain degree of publication bias,may reduce the credibility of the above results,so the results of this study are limited in strength.In the future,more prospective and large-scale clinical randomized controlled studies are needed to verify the effectiveness and safety of Jianpilishibushenhuoxue method in the treatment of chronic glomerulonephritis.