Objective To assess the efficacy and safety of Rhubarb and adjunvent drugs for chronic renal failure. Methods Electronic database searching including Medline, Cochrane Library and CBM from 1980 to Dec., 2000 was performed. Handsearching was applied to 15 kinds of nephrological and traditional Chinese medicine journals such as Chinese Journal of Nephology. Randomised and quasi-randomised trials concerning Rhubarb treatment for CRF were selected. The selected studies were assessed for their methodological quality and the data were extracted to perform the Meta-analysis. Results Eighteen randomised and quasi-randomised trials including 1 322 patients met the inclusion criteria, but their methodological quality was low. Compared to non-specific treatment, Rhubarb showed significant positive effects on relieving symptoms, lowering serum creatinine, improving HGB and adjusting disturbance of lipid metabolism. The effect of Rhubarb on reducing the number of death [OR 0.15, 95%CI (0.06 to 0.36), P=0.000] and the number of progressing into end-stage renal disease [OR 0.38, 95%CI (0.09 to1.64), P=0.19] was not confirmed because of the small sample size. Conclusions Rhubarb may have the same effect on CRF in the short-term observation. But its long-term effect of delaying the progression of CRF is still unclear. Well designed, randomised, double-blinded, placebo-controlled trials with long-term follow up and clinical related outcomes are warranted.
To diagnose and treat a patient with rare lupus erythematosus-like syndrome and antineutrophil cytoplasmic antibodies (ANCA) positive vasculitis with graves’ disease by applying the approach of evidence-based medicine. Clinical problems were raised based on the patient condition and PubMed (1966-2003), CBM (1978-2003), EMBASE (1974-2003) were searched for the related information. We found that the best explaination for this case was antithyroid drugs’ side effect, and the patient was obvious better after treatment.