Systematic Review Of Ligustrazin For Primary Nephritic Syndrome

Objective To assess the efficiency, safety and clinical economics of Ligustrazin for Primary nephritic syndrome. Methods Randomized controlled trials were applied for systematic reviews. Electronic and manual retrieve of Medline, Embase, Cochrane Library, CBMdisc and CEBM/CCD, SCI and relevant medical journals in China were applied to search the RCTs of Ligustrazin, glucocorticoids and/or immunosuppresants for Primary nephritic syndrome, and the RCTs were analysed with RevMan4.1. Results There were 13 randomized controlled trials with 675 cases involved. Jadad scores of all trials were 1. Meta-analysis showed that Ligustrazin significantly increased clinical efficiency (3.24%, P=0.001) , shortened the times of disappearance of proteinuria (6.30d, p=0.003) and edema (4.44d, p<0.00001), lowered serum creatine (38.75 n mol/L, p=0.008) , urea nitrogen (2.23mmol/L, p=0.004) , cholesterol (0.68 rnmol/L, p=0.008), triglyceride(0.34mmol/L, p=0.003) and proteinuria amount of 24 hours (0.36g/24h, p=0.04), increased serum albumin level(3.61g/L, p<0.00001), and improved fibrinogen level(0.96g/L, p=0.004), plasma viscosity (0.49mPa.s, p=0.007) , platelet aggregate ratio (0.18, p<0.00001), erythrocyte sedimentation(3.7Imm/h, p=0.0005)and erythrocyte electrophoresis time (2.21s, p<0.00001) . there was no signifcant difference with erythrocyte aggregate index (0.19, p=0.3). Compared withglucocorticoids therapy, Ligustrazin had obvious effects in adults group (3.31%, p=0.01 )and no significant effects in children group(3.13%, p=0.05). Sensibility-analysis showed that Ligustrazin significantly increased clinical efficiency (3.16%, P=0.02) . It has not been confirmed whether Ligustrazin could reduce the relapse of Primary nephritic syndrome. The clinical economics and severe side effects of Ligustrazin have not been reported. Asymmetry showed in "Funnel plot" may be related to publication bias, low quality of methodology and small-size in sample. Conclusions Based on glucocorticoids and/or immunosuppresants therapy, Ligustrazin does work and is safety in Primary nephritic syndrome in short-term observation, especially for patients with high-viscosity or temporary renal dysfunction. Compared with children, Ligustrazin has more obvious effects for adults. It has not been confirmed whether Ligustrazin could reduce the relapse of Primary nephritic syndrome. The clinical economics and severe side effects of Ligustrazin have not been reported. A rigorously designed, randomised, double-blind, placebo-controlled trial is required for evaluating the long-term effects and safety.