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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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. 川芎嗪配合中藥治療腎病綜合征高凝血癥臨床觀察[J]. 中國中醫急癥, 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. 邱麗,范培金,韓翠華.川芎嗪和黃芪注射液佐治腎病綜合征22例[J]. 醫藥導報, 2002; 21(6): 365～367.
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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. 李祖發,楊玉梅. 川芎嗪治療原發性腎病綜合征39例臨床觀察[J]. 黑龍江醫藥, 2001; 14(1): 33～34.
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Chinese Journal of Evidence-Based Medicine

Ligustrazine for Primary Nephrotic Syndrome:A Systematic Review

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