| Objective: Ig A nephropathy is a kind of is given priority to with Ig A immune globulin in the glomerular mesangial gathered for the characteristics of primary glomerular disease,at present in China and around the world are common,prevalence is different,different geographical area accounted for about 30% ~ 40% of the European primary glomerular disease,the prevalence rate of Asia is higher about 30% ~ 45%.Clinical manifestations of Ig A nephropathy patients vary greatly.Some asymptomatic patients were found to have microscopical hematuria,there were recurrent episodes of proteinuria and macroscopic hematuria,and some patients may be accompanied by diseases such as hypertension,nephrotic syndrome and renal failure.Up to 30 percent of patients may develop end-stage renal disease.The activation of the renin-angiotensin system(RAS system)is the key to the progression of Ig A nephropathy.RAS system blockers(ACEI/ARB)are recommended in the presence of small amounts of proteinuria or high blood pressure.RAS system blockers can reduce proteinuria in patients with Ig A nephropathy,protect renal function and delay the progression of the disease.In recent years,traditional Chinese medicine has been playing a prominent role in the prevention and treatment of nephropathy,among which huangkui capsule has been paid moreand more attention in clinical practice.Huangkui capsule prepared with huangshu sunflower extract has been verified by a large number of experiments and has been found to have a unique effect in the treatment of Ig A nephropathy.In particular,the combination of huangkui capsule and RASS system blockers has gradually been recognized by the vast number of clinical workers.However,as most of the randomized controlled trials(RCT)study samples are too small and not high quality,the conclusions obtained are difficult to be widely accepted.Therefore,high quality,large sample size and reasonable analysis results of research design are urgently needed.In view of the current situation,this paper comprehensively evaluated the efficacy and status of huangkui capsule combined with RAS system blocker in the treatment of Ig A nephropathy.Methods: Using the computer to retrieve the data knowledge service platform of ten thousand,VIP Chinese periodical service platform VIP,China hownet database of CNKI,Pub Med and Springer electronic periodicals and books about ambrette capsule in joint RASS system blockers in the treatment of Ig A nephropathy randomized controlled trial(RCT)research literature,languages,including Chinese and English.Chinese retrieval words include "huangkui","Ig A","ACEI/ARB",and English retrieval words include "huangkui" and "Ig A".The data required in the literature of this study were analyzed using revman5.3 software,and the main study indexes were remission rate,24-hour urinary protein quantification,serum albumin,blood creatinine,and glomerular filtration rate.And according to Cochrane Collaboration standard and Jadad quality rating method to search and evaluation of the quality of retrieved literature.Results: through the computer search of network database,of which ten thousand square data knowledge service platform to find relevant literature 72,VIP VIP find out 52 references consulting Chinese periodical service platform,China hownet database of CNKI find out with 55 references,Pub Med find 2,Springer electronic periodicals and books to find three articles,manual search out the zero article,retrieved 184 piece of literature.Full text and read the title,abstract and eliminate duplicate income documents,data index incomplete documents,a randomized controlled trial documents,animal experimental literature,cell experiment,document and review the literature review literature and intervention measures do not tally with the inclusion criteria,the final income 10 randomized controlled trial,708 patients were included in the analysis.Meta analysis results show that the use of ambrette capsule combined RAS system blockers group than simple use of RAS blocker grouping remission rate higher [OR = 3.63,95% CI(2.37,2.37),P < 0.00001),in the 24 hours urinary protein quantitative use of ambrette capsule combined RAS system blockers grouping more than the simple use of RAS blocker group reduced [MD = 0.38,95% CI(0.53,0.22).P < 0.00001],the grouping of using huangkui capsule combined with RAS system blockers in urea nitrogen was significantly lower than that of using RAS blockers alone [MD=-0.28,95%CI(-0.56,0.00),P=0.05],and the differences were statistically significant.There was no statistical difference in serum albumin,serum creatinine,and glomerular rate filtration.Conclusion: According to the results of meta-analysis,the clinical remission rate of the huangkui capsule group combined with RAS system blockers was higher,the reduction of urea nitrogen value and the reduction of24-hour urinary protein quantitative value were more significant in the group than the RASS system blockers alone,and the differences were statistically significant,which was consistent with the results reported in most domestic literatures.However,due to the generally low quality of the included literature,a larger sample is needed in the future,the study is of higher quality,multi-center and more scientific randomized controlled trial is designed toprovide a more accurate evaluation of huangkui capsule combined with RAS system blocker in the treatment of iga nephropathy. |
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