Ligustrazine for Primary Nephrotic Syndrome:A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

JIAN Xun , FAN Junming , LI Zi , LUO Hai , SU Baihai

Department of Nephrology; West China Hospital; Sichuan University; Chengdu 610041; China;

Corresponding author：

Keywords：

Ligustrazine; Nephrotic syndrome; Systematic review; Meta-analysis

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Objective 　To provide evidence for clinical practice by assessing the effectiveness and safety of Ligustrazine for primary nephrotic syndrome.
Methods 　We searched MEDLINE (1966.1-2002.12), EMBASE (1975-2002.12), CBM (1979.1-2002.12), Chinese Evidence-Based Medicine/Cochrane Centre Database (CEBM/CCD, Issue 4, 2002) , Cochrane Library, and SCI (1985-2002.12) and handsearched 15 kinds of journals (including Journal of Nephrology et al) (1980-2003.2) for the randomized controlled trials (RCTs).Jadad score was used to assess the quality of RCTs. The outcomes of short term and long term effectiveness, and adverse effect of the treatment were analyzed by RevMan 4.1.
Results 　Thirteen RCTs involving 675 patients met inclusion criteria. Jadad scores of each trial was 1 point. Meta-analysis of 4 studies showed that Ligustrazine had significant better short term effect [OR 4.24, 95% confidence interval (CI) 1.76 to 10.19], lowered 24 h urine protein (OR -0.36, 95% CI -0.71 to -0.02), improved renal function [ creatinine level in children group: (OR -3.34, 95% CI -5.25 to -1.43), creatinine level in adult group: (OR -48.29, 95% CI -68.24 to -28.35)], and increased serum albumin level (OR 3.61, 95% CI 2.61 to 4.61). Whether Ligustrazine had long term side effect was not confirmed. No adequate evidence showed that Ligustrazine could reduce the relapse rate of primary nephrotic syndrome.
Conclusions 　Meta-analysis of low quality RCTs suggest that Ligustrazine does work in primary nephritic syndrome in short term observation. No adequate evidence shows that Ligustrazine has severe side effect or can reduce the relapse rate of primary nephrotic syndrome. We can’t draw a conclusion that Ligustrazine is safe in primary nephrotic syndrome treatment.A rigorously designed, randomized, double blind, placebo controlled trial are required.

Citation： JIAN Xun,FAN Junming,LI Zi,LUO Hai,SU Baihai. Ligustrazine for Primary Nephrotic Syndrome:A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2004, 04(9): 627-633. doi: Copy

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1. 伊修彪.川芎嗪、黄芪注射液联用辅助治疗肾病综合征42例[J]. 井冈山医专学报, 2000; 7(1): 61～62.
2. ［15］Jin SX. The effect of Ligustrazine with Traditional Chinese Drug on Hypercoagulable state of nephrotic syndrome patients[J]. Journal of Chinese Traditional Chinese Medical Emergency,2001; 10(5): 270.
3. 金淑雪. 川芎嗪配合中药治疗肾病综合征高凝血症临床观察[J]. 中国中医急症, 2001; 10(5): 270.
4. ［16］Qiu L,Fan PJ,Han CH. The effect of Ligustrazine with Mongolian for 22 nephrotic syndrome patients[J]. Journal of Medicine, 2002; 21(6): 365-367.
5. 邱丽,范培金,韩翠华.川芎嗪和黄芪注射液佐治肾病综合征22例[J]. 医药导报, 2002; 21(6): 365～367.
6. ［17］Xu JF,Guo QZ,Song JG,Li YY. Clinic analysis of Mongolian with Ligustrazine for Primary nephrotic syndrome[J]. Journal of Inter- Mongolia national university (natural science),2002; 17(2): 151-152.
7. 许俊福,郭庆祝,宋嘉耕,李月英. 黄芪、川芎嗪治疗原发性肾病综合征临床分析[J]. 内蒙古民族大学学报(自然科学版),2002; 17(2): 151～152.
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14. ［21］Zhang FY,Zhang XH,Liu ZP. The effect of mass dosage Ligustrazine on Hypercoagulable state of nephrotic syndrome patients[J]. Journal of Bin Zhou Medical College, 2000; 23(4): 348.
15. 张付玉,张秀华,刘宗平. 大剂量川芎嗪治疗肾病综合征高粘血症[J]. 滨州医学院学报, 2000; 23(4): 348.
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17. 金星.雷公藤多甙片联合川芎嗪治疗老年性肾病综合征疗效观察[J]. 中国中西医结合肾病杂志, 2001; 2(6): 350.
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22. ［25］Huang LC,Zhan F. The effect of Ligustrazine with Glucocorticoid for 38 nephrotic syndrome patients[J]. Chinese Journal of Integrated Traditional Chinese and Western Medicine,1997; 17(8): 492-493.
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24. ［26］Zhuang YJ. The effect of Ligustrazine with Glucocorticoid for 25 nephrotic syndrome patients[J]. Practical Clinical First Aid Journal of Integrated Traditional Chinese and Western Medicine, 1998; 5(4): 179-180.
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27. 郭大庆,王钢,许陵冬.川芎嗪配合中西药治疗肾病综合征高粘滞血症临床观察[J]. 中国中西医结合杂志, 1998; 18(12): 741～742.
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31. 吴建平,沈世忠,杨忠民. 川芎嗪对肾病综合征肾功能、血脂及血流动力学的影响[J].中华肾脏病杂志, 1999; 15(3): 169.
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33. 崔雁.川芎嗪佐治肾病综合征22例分析[J]. 儿科药学杂志, 1999; 5(1): 32.
34. ［31］Li ZF,Yang YM. Observations on the curative effects of 39 nephritic syndrome treated by Ligustrazine[J]. Journal of Hei long jiang Medicine, 2001; 14(1): 33-34.
35. 李祖发,杨玉梅. 川芎嗪治疗原发性肾病综合征39例临床观察[J]. 黑龙江医药, 2001; 14(1): 33～34.
36. ［32］Zhang GH, Zhang RZ, Shen ZW, Wang Y, Li JF. The effect of Ligustrazine for children nephrotic syndrome[J]. Chinese Journal of Integrated Traditional Chinese and Western Medicine, 2001; 21(6): 463-464.
37. 张国华,张荣珍,申兆文,王瑛,李佳芬. 川芎嗪对小儿肾病综合征治疗的临床观察[J]. 中国中西医结合杂志, 2001; 21(6): 463～464.
38. ［33］Li ZH,Xing SJ,Huang T,Wang YQ. The effect of Ligustrazine on TX B2 and 6-Keto-PGF1α of Primary nephrotic syndrome children[J]. Journal of Guangxi Medicine, 2002; 24(11): 1 733-1 736.
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Chinese Journal of Evidence-Based Medicine

Ligustrazine for Primary Nephrotic Syndrome:A Systematic Review

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