Intervention Review

Chinese herbal medicine Huangqi type formulations for nephrotic syndrome

  1. Wei Yuan2,
  2. Juan Wang2,
  3. Taixiang Wu1,*

Editorial Group: Cochrane Renal Group

Published Online: 14 APR 2010

Assessed as up-to-date: 13 FEB 2008

DOI: 10.1002/14651858.CD006335.pub2

Database Title

Additional Information

How to Cite

Yuan W, Wang J, Wu T. Chinese herbal medicine Huangqi type formulations for nephrotic syndrome. Cochrane Database of Systematic Reviews 2008, Issue 2. Art. No.: CD006335. DOI: 10.1002/14651858.CD006335.pub2.

Author Information

  1. 1

    West China Hospital, Sichuan University, Chinese Cochrane Centre, Chinese EBM Centre, Chengdu, Sichuan, China

  2. 2

    West China Hospital, Sichuan University, Chengdu, Sichuan, China

*Taixiang Wu, Chinese Cochrane Centre, Chinese EBM Centre, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, Sichuan, 610041, China. txwutx@hotmail.com.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 14 APR 2010

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

At present, there is a lack of safe and effective drugs for nephrotic syndrome (NS). Huangqi type formulations have been used to treat nephrotic syndrome for years in China, however the effects and safety of these formulations have not been systematically reviewed.

Objectives

To assess the benefits and harms of Huangqi and Huangqi type formulations in treating NS in any age group, either as sole agents or in addition to other drug therapies.

Search methods

We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, Chinese Biomedicine Database (CBM), CNKI, VIP and reference lists of articles. There was no language restriction.
Date of most recent search: June 2006.

Selection criteria

All randomised controlled trials (RCTs) assessing the use of Huangqi or Huangqi type formulations in treating NS in adults and children, either as sole agents or in addition to other drug therapies.

Data collection and analysis

Two authors independently assessed study quality and extracted data. For dichotomous outcomes (remission, side effects and Inefficacy rate), results were expressed as relative risk (RR) and 95% confidence intervals (CI). Continuous outcomes (triglycerides cholesterol, plasma albumin) results were expressed as mean difference (MD) with 95% CI.

Main results

Three studies were identified (n = 128), all comparing Huangqi type formulations with placebo. Huangqi injection had a positive effect on plasma albumin (MD 6.90, 95% Cl 3.60 to 10.20) and cholesterol (MD 2.13, 95% Cl -2.97 to -1.29). Huangqi and red Chinese date reduced some adverse reactions (Cushing's syndrome: RR 0.55, 95% Cl 0.32 to 0.94; hormone reduced syndrome: RR 0.58, 95% Cl 0.39 to 0.85, respiratory tract infection: RR 0.27, 95% Cl 0.08 to 0.88), but no benefit on reducing relapse. Huangqi and Danggui had a positive effect on cholesterol (MD -0.85, 95% Cl -1.70 to 0.00).

Authors' conclusions

Huangqi type formulations may have some positive effects in treating NS by increasing plasma albumin and reducing blood cholesterol, Cushing's syndrome, hormone reduced syndrome and respiratory tract infection. However, limited by the lack of high quality clinical studies, we are unable to recommend Huangqi type formulations for NS. Large, properly randomised, placebo-controlled, double-blind studies are required.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Huangqi type formulations may relieve symptoms of nephrotic syndrome and reduce the adverse reactions of other drugs

Heavy proteinuria, hypoalbuminaemia, oedema and hypercholesterolaemia are the characters of nephrotic syndrome. At present, the primary drugs for nephrotic syndrome are corticosteroids, alkylating agents and cyclosporin. However there are many side effects associated with their use. This review identified three studies (128 participants) comparing Huangqi type formulations with placebo. The results of this review suggest that Huangqi type formulations may have a positive effect on nephrotic syndrome (by reducing some adverse reactions and improving cholesterol levels), however the evidence from three small studies is not conclusive.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

中藥黃耆對於腎病症後群的治療

至目前為止，並沒有一個有效且安全的藥物，可用於治療腎病症後群。雖然在中國黃耆用於治療腎病症後群已有數年之久，但並沒有一個整體性的回顧

目標

為了評估黃耆或含有黃耆成分之中藥單獨或合併其他藥物在不同年齡層中，治療腎病症後群的優缺點

搜尋策略

我們搜尋各資料庫：Cochrane對照試驗註冊資料庫，MEDLINE，EMBASE，CBM，CNKI，VIP等醫學文獻資料庫。而搜尋過程中並無語言的限制

選擇標準

所有隨機對照試驗 (randomised controlled trials, RCTs) 進行之研究文獻使用黃耆或含有黃耆成分之中藥在治療成人及小孩的腎病症候群

資料收集與分析

兩位作者獨立評估研究品質及其中的數據。對於二元資料結果(如緩解率，副作用及無效率)以相對危險性(RR)及95% 信賴區間表示。至於連續變相結果(如三酸酐油脂，膽固醇，白蛋白)則以平均差及95% 信賴區間表示

主要結論

總共分析三個研究實驗 (共128位患者) ，所有的研究均比較含黃耆成分之中藥及安慰劑之差別。黃耆注入可增加血中白蛋白(平均差為6.90，95% 信賴區間為3.6至10.20)及降低膽固醇(平均差為2.13，95% 信賴區間為 −2.97，至 −1.29)。黃耆和紅中能降低庫欣氏症候群，賀爾蒙降低症候群，呼吸道感染等；但對於降低腎病症後群的復發並無任何效果。黃耆和當歸則能降低膽固醇 (平均差為 −0.85，95% 信賴區間為 −1.7至0)

作者結論

含黃耆成分之中藥可能藉由增加血清中白蛋白，降低膽固醇，減少庫欣氏症候群賀爾蒙降低症候群，呼吸道感染，因而可用於治療腎病症候群。然而因缺乏高品質之臨床研究，因此作者無法建議是否可用黃耆來治療腎病症候群，這仍需要大型，隨機性，有對照組的雙盲研究來進一步證實

翻譯人

本摘要由馬偕醫院黃筱雯翻譯。

此翻譯計畫由臺灣國家衛生研究院 (National Health Research Institutes, Taiwan) 統籌。

總結

腎病症候群的特色包括：重度蛋白尿、水腫、高膽固醇血症、低白蛋白血症。目前為止，用於治療腎病症候群的藥物包括類固醇、烷化基藥劑及環孢靈素。然而每種藥物皆有許多副作用。本篇文章分析三篇研究(共128位病人)。這些研究結果顯示含黃耆成分之中藥對於腎病症候群具有治療效果並能降低副作用，改善膽固醇濃度，然而從這三篇研究所獲得之證據並無結論

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