黄芪及其制剂对原发性肾病综合征患者免疫调节作用的系统评价-中西医结合临床专业毕业论文.docxVIP

成都中医药大学 成都中医药大学 2002 级七年制学位论文 PAGE PAGE 1 中文摘要 目的：用循证医学的方法，评价黄芪在原发性肾病综合征患者中 体液及细胞免疫调节的疗效及安全性，为中西医结合治疗减少原发性 肾病综合征感染并发症方面提供科学依据。 方法：按照国际 Cochrane 协作网的系统评价方法，计算机检索 OVID 平台上的 Cochrane 图书馆随机对照试验库（CCTR）、 MEDLINE、清华期刊全文数据库（CNKI）、维普期刊网（VIP）、万 方数据库；手工检索 08 年下半年的 10 余种中文核心期刊。对所纳入 的研究进行方法学质量评价，用 Cochrane 协作网提供的 RevMan 5.0.17 进行统计分析。 结果：共检索到 7 个符合纳入标准的临床试验，共计 478 例病人。 Meta-分析显示中医药治疗可以提高免疫球蛋白 IgG 水平、调节肾病 综合征患者 T 淋巴细胞亚群，能减少感染和肾病复发率。 结论：黄芪应用于肾病综合征中在有调节机体免疫的作用，在减 少感染的并发症方面可能是一种有前景的治疗手段；黄芪为主的中药 对成人原发性肾病综合征治疗的随机对照试验，确切疗效有待于设计 严格的多中心、大样本随机对照试验进一步证实。 关键词：黄芪 原发性肾病综合征 体液免疫 细胞免疫 随机对照 试验 系统评价 ABSTRACT Objectives Using the EBM method to evaluate the efficiency and safety of Astragalus treating with the primary nephrotic syndrome patients in the regulatory of the body’s immune system.In order to find a prospective way to reduce the infection rate of the primary nephrotic syndrome patients. Search strategy We searched the Cochrane Controlled Trials Registe(CCTR), MEDLINE(1996to2008), and China National Konwledge infrastructure (CNKI), VIP,WanFang data .The Chinese journals related to TCM in 2008 searched by hand .Two authors independently assessed trial quality and extracted data from these Randomized Controlled Trails, then imported them into the Mete-analysis by RevMan5.0.17. Results Seven RCTs for a total of 478 patients are included in the study. The outcome of Meta-analysis show that Astragalus with modern medicine treatment can increase the level of immunoglobulin G, mediate the patients’T lymphocyte subsets, and also decrease the infection rate and relapse rate. Conclusions Astragalus used in the nephrotic syndrome may be a prospective way in regulate patients’immune system in order to reduce the complications of infection; however, the exact effect of Astragalus-based Chinese medicine for the treatment of primary nephrotic syndrome, should be further confirmed by strict designed of multi-center, large sample randomized controlled trials. Keywords radix astragali/astragalus; primar