Meta - Analysis Of Proteinuria In Patients With Chronic Glomerulonephritis Treated By Integrated Traditional Chinese And Western Medicine

Purpose：To investigate the differences of curative effect betweencombined therapy of Chinese and Western medicine and simple westernmedicine therapy for the treatment of CGN; to provide that curative effectin treating chronic nephritis and reduction of24hours urine protein bycombining traditional Chinese and Western medicine therapy with basis forevidence-based medicine.Method：Comprehensive collect Clinical research literature of thattraditional Chinese medicine combined with western medicine in treatmentof CGN by manual search and computer retrieval,and then make certain theinclusion and exclusion criteria. To extract data and evaluate risk biasfor eligible randomized controlled or half a randomized controlled trial.Statistical analyse the quantitative change of24hours before and afterthe treatment of proteinuria, CGN overall curative effect,the improvementof clinical symptoms and adverse reactions by using RevMan5.2software.Descriptive analysis of data can’t Meta analysis.Results：Atotalof24literatures;1762patients(813casesintreatmentgroup,859cases in control group) were included. Reduction of24hoururinary protein quantitative Meta analysis showed that:[SMD=-0.8,95%CI(-0.98,-0.61), Z=8.55,(P<0.00001)], the treatment group and the controlgroup had significant difference, the sensitivity analysis results werestable, and publication bias may existed. Analysis of treatingproteinuria efficacy:[OR=4.44,95%CI (1.72,11.49), Z=3.07,(P=0.002)],the results are robust. Meta-analysis of CGN clinical curative effect:[OR=3.84,95%CI (2.90,5.10), Z=9.34,(P<0.00001)], with statistical significance;the analysis result was stable; there existed the smallpossibility of publication bias. Meta-analysis of urine red blood cellcount:[SMD=-0.44,95%CI (-0.63,-0.24), Z=4.42,(P<0.00001)], there wassignificant difference between the results, more stable; Analysis ofsyndromes:[OR=3.66,95%CI (2.21,6.05), Z=5.06,(P<0.00001)], stableresult, publication bias less likely; Analysis of symptom integral effect:single study indicated that added with TCM drug therapy was better thansingle western medicine treatment in improving symptoms and signs had moreadvantages. Meta-analysis of the effect on the blood creatinine:heterogeneity was large[Chi2=230.05, P<0.00001, I2=90%], subgroup notweaken the heterogeneity, so apply stochastic model analysis,[SMD=-0.61,95%CI (-0.94,-0.29), Z=3.72,(P=0.0002)], there was significantdifference between the groups, the results are robust, publication biasmay exist. Impact on the endogenous creatinine clearance rate：[MD=5.42,95%CI (2.41,8.42), Z=3.53,(P=0.0004)], sensitivity analysis resultswere stable.Conclusion：Combine traditional Chinese and western medicine treatmentgroup on the reduction of24h proteinuria quantitative treatment effectis better compared with the western medicine control group, stabilityanalysis results, but there are reporting bias may.Traditional Chinesemedicine combined with conventional western medicine treatment of CGN canimprove the overall efficacy of CGN, compared with western medicinetreatment is more superior. Initially showed the combination of Chineseand Western medicine treatment in improving the overall clinical symptoms,reduce the count and blood red blood cells in urine, reduce creatinineand improve the endogenous creatinine clearance rate trend is more obviousthan simple western medicine treatment. Adverse reaction and safetyanalysis did not get a clear conclusion of comparison. Based on a smallsample of high risk of bias, this proves insufficient strength.