|Tripterygium Preparations for the Treatment of CKD: A Systematic Review and Meta-analysis|
|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|
|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|
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.
|资助机构||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|
|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
|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.|
|APA||Zhu, Bin.,Wang, Ying.,Jardine, Meg.,Jun, Min.,Lv, Ji-Cheng.,...&Perkovic, Vlado.(2013).Tripterygium Preparations for the Treatment of CKD: A Systematic Review and Meta-analysis.AMERICAN JOURNAL OF KIDNEY DISEASES,62(3),515-530.|
|MLA||Zhu, Bin,et al."Tripterygium Preparations for the Treatment of CKD: A Systematic Review and Meta-analysis".AMERICAN JOURNAL OF KIDNEY DISEASES 62.3(2013):515-530.|