PDF(Pubmed)
Abstract：
UNASSIGNED: IgA nephropathy (IgAN), a condition posing a significant threat to public health, currently lacks a specific treatment protocol. Research has underscored the potential benefits of traditional Chinese medicine (TCM) for treating IgAN. Nevertheless, the effectiveness of various intervention strategies, such as combining TCM with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs), lacks a comprehensive systematic comparison. Therefore, this study aimed to conduct a network meta-analysis to assess the clinical efficacy of ACEIs, ARBs, TCM, and their combinations in treating IgAN to offer novel insights and approaches for the clinical management of IgAN.
UNASSIGNED: A systematic review conducted until November 2023 included relevant literature from databases such as PubMed, Embase, Cochrane, Web of Science, Scopus, CNKI, and Wanfang. Two independent researchers screened and assessed the data for quality. Network and traditional meta-analyses were performed using Stata 18.0 and RevMan 5.3 software, respectively. Outcome measures included 24-h urinary protein quantification (24 hpro), estimated glomerular filtration rate (eGFR), serum creatinine (Scr), blood urea nitrogen (BUN), and adverse event incidence rates (ADRs). Forest plots, cumulative ranking probability curves (SUCRA), and funnel plots generated using Stata 18.0 facilitated a comprehensive analysis of intervention strategies\' efficacy and safety.
UNASSIGNED: This study included 72 randomized controlled trials, seven interventions, and 7,030 patients. Comparative analysis revealed that ACEI + TCM, ARB + TCM combination therapy, and TCM monotherapy significantly reduced the levels of 24 hpro, eGFR, Scr, and BUN compared to other treatment modalities (p < 0.05). TCM monotherapy demonstrated the most favorable efficacy in reducing eGFR levels (SUCRAs: 78%), whereas the combination of ARB + TCM reduced Scr, 24 hpro, and BUN levels (SUCRAs: 85.7%, 95.2%, and 87.6%, respectively), suggesting that ARB + TCM may represent the optimal intervention strategy. No statistically significant differences were observed among the various treatment strategies in terms of ADR (p > 0.05).
UNASSIGNED: The combination of ACEI or ARB with TCM demonstrated superior efficacy compared to ACEI/ARB monotherapy in the treatment of IgAN without any significant ADRs. Therefore, combination therapies can be used to enhance therapeutic outcomes based on individual patient circumstances, highlighting the use of TCM as a widely applicable approach in clinical practice.
UNASSIGNED: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023476674.
UNASSIGNED: A systematic review conducted until November 2023 included relevant literature from databases such as PubMed, Embase, Cochrane, Web of Science, Scopus, CNKI, and Wanfang. Two independent researchers screened and assessed the data for quality. Network and traditional meta-analyses were performed using Stata 18.0 and RevMan 5.3 software, respectively. Outcome measures included 24-h urinary protein quantification (24 hpro), estimated glomerular filtration rate (eGFR), serum creatinine (Scr), blood urea nitrogen (BUN), and adverse event incidence rates (ADRs). Forest plots, cumulative ranking probability curves (SUCRA), and funnel plots generated using Stata 18.0 facilitated a comprehensive analysis of intervention strategies\' efficacy and safety.
UNASSIGNED: This study included 72 randomized controlled trials, seven interventions, and 7,030 patients. Comparative analysis revealed that ACEI + TCM, ARB + TCM combination therapy, and TCM monotherapy significantly reduced the levels of 24 hpro, eGFR, Scr, and BUN compared to other treatment modalities (p < 0.05). TCM monotherapy demonstrated the most favorable efficacy in reducing eGFR levels (SUCRAs: 78%), whereas the combination of ARB + TCM reduced Scr, 24 hpro, and BUN levels (SUCRAs: 85.7%, 95.2%, and 87.6%, respectively), suggesting that ARB + TCM may represent the optimal intervention strategy. No statistically significant differences were observed among the various treatment strategies in terms of ADR (p > 0.05).
UNASSIGNED: The combination of ACEI or ARB with TCM demonstrated superior efficacy compared to ACEI/ARB monotherapy in the treatment of IgAN without any significant ADRs. Therefore, combination therapies can be used to enhance therapeutic outcomes based on individual patient circumstances, highlighting the use of TCM as a widely applicable approach in clinical practice.
UNASSIGNED: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023476674.
摘要：
■IgA肾病（IgAN），对公众健康构成重大威胁的疾病，目前缺乏具体的治疗方案。研究强调了中药治疗IgAN的潜在益处。然而，各种干预策略的有效性，例如将中药与血管紧张素转换酶抑制剂（ACEI）或血管紧张素II受体阻滞剂（ARB）相结合，缺乏全面系统的比较。因此,这项研究旨在进行网络荟萃分析，以评估ACEI的临床疗效，ARBs,TCM,以及它们在治疗IgAN方面的组合为IgAN的临床管理提供了新的见解和方法。
■直到2023年11月进行的系统评价包括来自PubMed等数据库的相关文献，Embase,科克伦,WebofScience,Scopus,CNKI,还有万方。两名独立研究人员筛选并评估了数据的质量。使用Stata18.0和RevMan5.3软件进行网络和传统荟萃分析，分别。结果指标包括24小时尿蛋白定量（24hpro），估计肾小球滤过率(eGFR)，血清肌酐(Scr),血尿素氮(BUN),和不良事件发生率（ADR）。森林地块，累积排名概率曲线(SUCRA)，使用Stata18.0生成的漏斗图有助于对干预策略的有效性和安全性进行全面分析。
■这项研究包括72项随机对照试验，七项干预措施，和7,030名患者。比较分析表明，ACEI+中医，ARB+中医综合疗法，和中药单药治疗显着降低了24hpro的水平，eGFR,Scr,和BUN与其他治疗方式相比（p<0.05）。中药单药治疗在降低eGFR水平方面表现出最有利的疗效（SUCRAs：78％），而ARB+TCM的组合降低了Scr，24hpro，和BUN水平（SUCRAs：85.7%，95.2%,和87.6%，分别)，提示ARB+TCM可能代表最佳干预策略。在ADR方面，各种治疗策略之间没有观察到统计学上的显着差异（p>0.05）。
■在治疗IgAN中，与ACEI/ARB单一疗法相比，ACEI或ARB与中药的组合显示出更好的疗效，而没有任何明显的不良反应。因此,联合疗法可用于根据患者的具体情况提高治疗效果，强调在临床实践中使用中医作为一种广泛适用的方法。
■https://www.crd.约克。AC.英国/PROSPERO/,标识符CRD42023476674。
■直到2023年11月进行的系统评价包括来自PubMed等数据库的相关文献，Embase,科克伦,WebofScience,Scopus,CNKI,还有万方。两名独立研究人员筛选并评估了数据的质量。使用Stata18.0和RevMan5.3软件进行网络和传统荟萃分析，分别。结果指标包括24小时尿蛋白定量（24hpro），估计肾小球滤过率(eGFR)，血清肌酐(Scr),血尿素氮(BUN),和不良事件发生率（ADR）。森林地块，累积排名概率曲线(SUCRA)，使用Stata18.0生成的漏斗图有助于对干预策略的有效性和安全性进行全面分析。
■这项研究包括72项随机对照试验，七项干预措施，和7,030名患者。比较分析表明，ACEI+中医，ARB+中医综合疗法，和中药单药治疗显着降低了24hpro的水平，eGFR,Scr,和BUN与其他治疗方式相比（p<0.05）。中药单药治疗在降低eGFR水平方面表现出最有利的疗效（SUCRAs：78％），而ARB+TCM的组合降低了Scr，24hpro，和BUN水平（SUCRAs：85.7%，95.2%,和87.6%，分别)，提示ARB+TCM可能代表最佳干预策略。在ADR方面，各种治疗策略之间没有观察到统计学上的显着差异（p>0.05）。
■在治疗IgAN中，与ACEI/ARB单一疗法相比，ACEI或ARB与中药的组合显示出更好的疗效，而没有任何明显的不良反应。因此,联合疗法可用于根据患者的具体情况提高治疗效果，强调在临床实践中使用中医作为一种广泛适用的方法。
■https://www.crd.约克。AC.英国/PROSPERO/,标识符CRD42023476674。
