ObjectiveTo evaluate the efficacy of western conventional treatment based on traditional Chinese medicine retention enema on patients with hepatic encephalopathy. MethodsSuch databases as the Cochrane Library, PubMed, EMbase, VIP, CNKI, CBM and WanFang Database were searched from the inception to November 2013 to collect randomized controlled trials (RCTs) about Western conventional treatment based on traditional Chinese medicine retention enema to treat hepatic encephalopathy, and the references of the included literature were also retrieved. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and evaluated and cross-checked the methodological quality. Then meta-analysis was conducted using RevMan 5.1 software. ResultsA total of 26 RCTs involving 1 691 patients were included. The subgroup analyses based on the length of intervention time showed that when the course of treatment intervention was less than one, the overall effective rate of the Chinese herbal retention enema group was higher than that of the control group, with a significant difference[RR=1.34, 95%CI (1.25, 1.44), P<0.000 01]; after more than one course of treatment intervention, the overall effective rate of the Chinese herbal retention enema group was higher than that of the control group, with a significant difference[RR=1.34, 95%CI (1.21, 1.48), P<0.000 01]. ConclusionOn the basis of available evidence, the western medicine treatment based on traditional Chinese medicine retention enema for hepatic encephalopathy has a certain effect. However, the heterogeneity among the included studies is large. It is necessary to design multicenter, strictly randomized and double-blind test controlled trials with large samples to validate these conclusions and to further confirm the clinical curative effect.
ObjectiveTo systematically review the efficacy and safety of tripterygium wilfordii Hook F (TwHF) in treatment of IgA nephropathy. MethodsThe Cochrane Library (Issue 4, 2014), PubMed, EMbase, CBM, CNKI, VIP and WanFang Data were searched up to April 28th, 2004 to collect randomized controlled trials (RCTs) about the efficacy and safety of TwHF in treatment of IgA nephropathy. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality of included studies. Metaanalysis was then conducted using RevMan 5.2 software. ResultsA total of 10 RCTs involving 521 patients were finally included. The results of meta-analysis showed that:a) compared with MMF group, TwHF group had better outcomes in complete remission (CR) (OR=2.01, 95%CI 1.04 to 3.87, P=0.04), total remission (TR) (OR=3.17, 95%CI 1.22 to 8.23, P=0.02), 24-hour urinary protein content (MD=2.61, 95%CI 1.34 to 3.88, P<0.000 1), and level of serum albumin (MD=-6.42, 95%CI -9.13 to -3.71, P<0.000 01); and b) compared with ACEI (ARB) group, TwHF group had better outcomes in complete remission (CR) (OR=4.25, 95%CI 2.63 to 6.86, P<0.000 01), total remission (TR) (OR=4.15, 95%CI 2.33 to 7.40, P<0.000 01), 24-hour urinary protein content (MD=1.15, 95%CI 0.63 to 1.66, P<0.000 1), and level of serum albumin (MD=-5.18, 95%CI -8.96 to -1.41, P=0.007), all with significant differences. ConclusionTwHF has favourable therapeutic efficacy and safety in treatment of IgA nephropathy. Due to limited quantity and quality of the included studies, the above conclusion should be verified by further conducting more high quality, large-scale, multicentre RCTs.