目的:运用网状Meta分析的方法评估中成药联合糖皮质激素(glucocorticoid, GC)治疗原发性肾病综合征(primary nephrotic syndrome, PNS)的疗效。方法:检索中成药联合GC治疗PNS的随机对照试验。在筛选文献、提取资料和评价偏倚风险后,对所纳入的指标进行网状Meta分析。结果:共纳入31篇文献,2275例PNS患者。结果显示,在提高总有效率、降低24 h尿蛋白定量方面,5种中成药联合GC治疗成人PNS优于单纯GC治疗。概率排序显示,在提高总有效率方面,昆仙胶囊排第一位;在升高血浆白蛋白方面,雷公藤制剂排第一位;在降低尿素氮方面,黄葵胶囊排第一位。结论:中成药联合GC的方案可提高PNS的治疗效果。Objective: To evaluate the efficacy of different Chinese patent medicines combined with glucocorticoid in treatment of primary nephrotic syndrome (PNS) by Network Meta analysis. Methods: Randomized controlled trial of Chinese patent medicine combined with glucocorticoid in treatment of PNS was retrieved. After screening the literature, extracting data and evaluating bias risk, the included indicators were analyzed by Network Meta analysis. Results: A total of 31 articles were included, involving 2275 patients with PNS. The results showed that in terms of improving the total effective rate and reducing 24-hour urinary protein, five kinds of Chinese patent medicines combined with glucocorticoid were better than glucocorticoid alone in the treatment of adult PNS. SUCRA showed that in terms of improving the total effective rate, Kunxian capsule ranks first;in terms of increasing the level of albumin, Tripterygium pharmaceutical preparation ranks first;in terms of reducing urea nitrogen, Huangkui Capsule ranks first. Conclusion: Chinese patent medicine combined with glucocorticoid can improve the therapeutic effect of PNS.
