The benefits and harms of Chinese medicinal herbs for the treatment of rapidly progressive glomerulonephritis in adult patients

Abstract Objective The aim of this review was to assess the benefits and harms of Chinese medicinal herbs for the treatment of rapidly progressive glomerulonephritis (RPGN) in adult patients. Methods Our study included only randomized controlled trials (RCTs). We designed a strategy for searching the EMBASE, CENTRAL, PubMed, CBM, CNKI, and VIP. All studies were analyzed using the criteria of the Cochrane Handbook. All studies included were assessed the risk of bias. Review Manager ver. 5.3.5 was used for the data analysis. GRADE profiler was used to evaluate quality. Results Two studies were studied (74 Chinese participants were included). We found that compared with supportive therapies combined with specific therapies, Chinese medicinal formulae plus supportive therapies combined with specific therapies significantly reduced the serum creatinine levels (SCr; two studies, 62 participants: mean difference (MD), -145.93 μmol/L; 95% confidence interval (CI), -236.75 to –55.11; I2=0%) and utilization number of methylprednisolone and prednisone (two studies, 74 participants: MD, -1.64 g; 95% CI, -1.87 to -1.40; I2=0%). Conclusion Our study suggested that there were insufficient evidences to confirm that the use of Chinese medicinal formulae for adults with RPGN was beneficial and safe.

摘要 目的
本综述旨在评估中药治疗成人急进性肾小球肾炎（rapidly progressive glomerulonephritis, RPGN）的获益与不良风险。

方法
本研究仅纳入随机对照试验（randomized controlled trials, RCTs）。我们制定了针对EMBASE、CENTRAL、PubMed、中国生物医学文献数据库（CBM）、中国知网（CNKI）及维普资讯网（VIP）的文献检索策略。所有研究均依据《考克兰手册》（Cochrane Handbook）的评价标准进行分析，并对纳入研究的偏倚风险进行评估。数据分析采用Review Manager 5.3.5版完成，证据质量评价则使用GRADE profiler工具。

结果
本研究共纳入2项相关研究，总计74名中国受试者。结果显示，相较于支持疗法联合特异性治疗方案，中药方剂联合支持疗法及特异性治疗可显著降低血清肌酐水平（serum creatinine levels, SCr；2项研究，62名受试者：均差（mean difference, MD）为-145.93 μmol/L；95%置信区间（confidence interval, CI）为-236.75~-55.11；I²=0%），同时减少甲基泼尼松龙与泼尼松的总使用剂量（2项研究，74名受试者：均差为-1.64 g；95%置信区间为-1.87~-1.40；I²=0%）。

结论
本研究表明，目前尚无足够证据证实成人急进性肾小球肾炎患者使用中药方剂治疗具有获益性与安全性。