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学科主题: 临床医学
题名:
Tripterygium Preparations for the Treatment of CKD: A Systematic Review and Meta-analysis
作者: Zhu, Bin1,2; Wang, Ying1; Jardine, Meg1; Jun, Min1; Lv, Ji-Cheng1,3; Cass, Alan1; Liyanage, Thaminda1; Chen, Hong-Yu2; Wang, Yong-jun2; Perkovic, Vlado1
关键词: Tripterygium ; traditional Chinese medicine ; Chinese herbs ; chronic kidney disease ; systematic review ; meta-analysis ; proteinuria ; kidney function ; glomerular disease
刊名: AMERICAN JOURNAL OF KIDNEY DISEASES
发表日期: 2013-09-01
DOI: 10.1053/j.ajkd.2013.02.374
卷: 62, 期:3, 页:515-530
收录类别: SCI
文章类型: Review
WOS标题词: Science & Technology
类目[WOS]: Urology & Nephrology
研究领域[WOS]: Urology & Nephrology
关键词[WOS]: UNILATERAL URETERAL OBSTRUCTION ; CHINESE HERBAL MEDICINE ; CHRONIC KIDNEY-DISEASE ; WILFORDII HOOK-F ; NF-KAPPA-B ; CLINICAL-TRIALS ; TRIPTOLIDE ; CELLS ; RATS ; MULTIGLYCOSIDE
英文摘要:

Background: Preparations of the herb Tripterygium wilfordii Hook F are used widely for the treatment of chronic kidney disease in China. The efficacy and safety of Tripterygium preparations still have not been fully identified.

Study Design: Systematic review and meta-analysis.

Setting & Population: Patients with chronic kidney disease.

Selection Criteria for Studies: Randomized controlled trials.

Intervention: Tripterygium preparations (Tripterygium glycoside tablets, Tripterygium hypoglaucum Hutch tablets, and Tripterygium granules or extracts) versus placebo, standard care, or other immunosuppressive treatment.

Outcomes: Weighted mean difference and summary estimates of relative risk (RR) reductions with 95% CIs were calculated with a random-effects model. Outcomes analyzed included change in proteinuria, serum creatinine level, and creatinine clearance rate, as well as remission and relapse rate and drug-related adverse events.

Results: We identified 75 trials that included 4,386 participants. Overall, Tripterygium therapy reduced proteinuria by protein excretion of 628 (95% CI, -736 to -521) mg/d and reduced serum creatinine level by 0.12 (95% CI, -0.17 to -0.06) mg/dL compared with controls (both P < 0.001) in a range of kidney conditions. Tripterygium preparations also increased the rate of complete remission by 56% (95% CI, 32%-85%; P < 0.001) and of complete or partial remission by 24% (95% CI, 17%-31%; P < 0.001) while reducing relapse by 58% (95% CI, 42%-69%; P < 0.001). Tripterygium preparations increased the rate of liver function test result abnormalities (RR, 4.03; 95% CI, 2.24-7.25; P < 0.001) and altered menstruation (RR, 5.29; 95% CI, 2.09-13.38; P < 0.001).

Limitations: Suboptimal study quality, significant heterogeneity in the primary outcome.

Conclusions: Tripterygium preparations may have nephroprotective effects, but high-quality trials are required to reliably determine the balance of benefits and harms. (C) 2013 by the National Kidney Foundation, Inc.

语种: 英语
项目资助者: International Society of Nephrology ; Asian Pacific Society of Nephrology ; CREED ; National Health and Medical Research Council ; Royal Australasian College of Physicians ; Australasian Kidney Trials Network ; Heart Foundation
WOS记录号: WOS:000324023700013
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/60595
Appears in Collections:北京大学第一临床医学院_肾脏内科_期刊论文

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作者单位: 1.Univ Sydney, George Inst Global Hlth, Sydney, NSW 2006, Australia
2.Hangzhou Hosp Tradit Chinese Med, Dept Nephrol, Hangzhou, Zhejiang, Peoples R China
3.Peking Univ First Hosp, Div Nephrol, Peking Univ Inst Nephrol, Beijing, Peoples R China

Recommended Citation:
Zhu, Bin,Wang, Ying,Jardine, Meg,et al. Tripterygium Preparations for the Treatment of CKD: A Systematic Review and Meta-analysis[J]. AMERICAN JOURNAL OF KIDNEY DISEASES,2013,62(3):515-530.
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