Meta-analysis Of The Efficacy And Safety Of Tripterygium Glycosides Combined With Hormones In The Treatment Of Idiopathic Membranous Nephropathy

Objective:Using Meta analysis method to evaluate the efficacy and safety of Tripterygium wilfordii tablets combined with hormone in the treatment of idiopathic membranous nephropathy.Methods:Systematically search of Cochrane(Database establishment-2016 July),MEDLINE(Database establishment-2016 July),EMBASE OVID(Database establishment-2016 July),Pubmed(Database establishment-2016 in July),CNKI database(Database establishment-2016 July),Wanfang(Database establishment-2016 July),VIP(Database establishment-2016 July)and Sino Med(Database establishment-2016July)database,with Tripterygium glycosides,Idiopathic membranous nephropathy,Nephrotic syndrome and Chinese as keywords,data extraction and quality evaluation of the follow-up study to meet the requirements,and analyzed by Revman 5.3 software.Results:according to the search strategy for a total of 126 articles were screened by reading the title and abstrac,full text reading when necessary according to the inclusion and exclusion criteria included 11 studies(10 RCT and 1 cohort studies),a total of 874 patients in the experimental group(Tripterygium glycoside tablet plus hormone group)in 438cases,the control group(other treatment group)436cases.All cases were treated with glucocorticoid plus tripterygium glycosides tablets.Through the analysis of each research data the total remission rate(1.35,1.95),[RR=1.62 P<0.00001][RR=1.21,the total remission rate(1.12,1.30),P<0.0001],Tripterygium Glycosides plus hormone therapy within 3 months of the complete remission rate of[RR=1.44(1.01,2.04)P=0.04],[RR=1.25,the total remission rate(1.06,1.48),P=0.009],Tripterygium Glycosides plus hormone therapy 6 months of treatment,the complete remission rate of[RR=1.74(1.38,2.17,P<0.00001]),the total efficiency of[RR=1.28(1.16,1.41,P<0.00001]).The Meta analysis shows that the results were statistically significant,indicating the use of Tripterygium combined with hormone therapy group compared with the control group,after treatment,the complete remission rate and overall response rate differences,and show that the therapy is better than Tripterygium combined with hormone treatment of idiopathic membranous nephropathy in the control group.As a kind of immunosuppressive agent,Tripterygium wilfordii tablets should be paid attention to in clinical application.The adverse reaction of statistics of this research mainly abnormal liver function,infection,leukopenia,abnormal glucose tolerance,according to the results of this study,abnormal liver function,gastrointestinal reaction,amenorrhea and incidence of side effects is relatively high,but compared with the control group,no significant difference.Conclusion:The effect of Tripterygium wilfordii tablets combined with hormone in the treatment of idiopathic membranous nephropathy was better,and the side effects were not significantly increased.