System Evaluation Of Huangkui Capsule Combined With ARB Drugs In The Treatment Of IgA Nephropathy

Purpose: Through systematic review of Huangkui capsule combined with ARB drugs in the treatment of IgA nephropathy,to provide reliable evidence for its clinical application.Method:(1)Through the electronic database retrieval and manual retrieval,collect medical journals,academic conferences,dissertation and unpublished literature but have access to clinical data in the literature which publised before December 2015 and associated with the ARB drugs in the treatment of IgA nephropathy randomized controlled trial research.(2)According to the inclusion criteria and exclusion criteria,screened in literature,the quality evaluation of the literature of the included,and from two aspects of qualitative and quantitative analysis the literature.Quantitative analysis of literatures were in accordance with the effect of the amount of combined statistics,using Rveman5.3 for meta analysis.Result:(1)A total of 7 randomized controlled trials with 395 patients were included.All the literature which were included are all chinese literature.Only two studies used appropriate random allocation methods,other research had not been described randomized method,all studies did not mention hidden randomized,double blinded,and lacked of lost to follow-up and exit record.Based on the modified JADAD scoring criteria,the literature included are of low quality,one literature is three points,the rest of the six literature are all two points.(2)Meta analysis results showed that compared with ARB drugs combined with conventional treatment group,Huangkui capsule combined with ARB drugs and conventional therapy on the clinical curative effect is better[OR=3.5,95% CI(1.4,1.4),P=0.0007].In terms of reducing the 24 hours urinary protein quantitative[MD=0.30,95%CI(0.39,0.21),P< 0.00001],improving urea nitrogen [MD = 0.29,95% CI(0.58,0.01),P =0.04]and fibrinogen[MD=-0.99,95% CI(-2.07,4.04),P=0.53]has a certain advantage.In terms of serum creatinine [MD=2.37,95%CI(6.21,6.21),P =0.22],serum albumin [MD =0.55,95% CI(1.31,1.31),P =0.16],systolic blood pressure [MD= 0.72,95% CI(4.00,4.00),P= 0.67],diastolic blood pressure [MD=0.66,95% CI(2.12,2.12),P=0.64] and glomerular filtration rate [MD=-0.99,95% CI(-2.07,4.04),P=0.53]has no difference.Four articles in the study of the included articles described the adverse reactions,two articles had not occurred adverse reaction,two articles described the treatment group and control group had appear a dry cough,dizziness,abdominaldistension clinical symptoms mild adverse reactions [OR = 0.74,95% CI(0.16,0.16),P =0.70].Conclusion: Compared with ARB drugs combined with conventional treatment group,Huangkui capsule combined with ARB drugs and conventional therapy on the clinical curative effect is better,can effectively reduce the 24 hours urinary protein excretion,improve the level of urea nitrogen and fibrinogen,may not affect the level of creatinine,serum albumin,blood pressure and glomerular filtration rate.