Abstract:
Objective
To systematically evaluate the efficacy of traditional Chinese medicine combined with cyclophosphamide in the treatment of refractory nephrotic syndrome in children, and provide evidence-based evidence for clinical application.
Methods
Retrieve systematically the CNKI, Wanfang Data, VIP, CBM, PubMed, EMbase and The Cochrane Library databases. The publication time was from the inception of the database to June 1st, 2019.According to the inclusion and exclusion criteria, a randomized controlled trial of Chinese medicine combined with cyclophosphamide in the treatment of children with refractory nephrotic syndrome was selected. The relevant data were recorded. The quality of the literature was evaluated by the standard developed by the Cochrane Collaboration. Meta analysis was performed by RevMan5.3 software.
Results
A total of 10 studies involving 758 children were included.Metaanalysis showed that the combination of traditional Chinese medicine with cyclophosphamide significantly increased the total effective rate compared with the control group［RR=1.16, 95%CI(1.10, 1.23), P<0.000 01］, increased the total cure rate［RR=1.33 95%CI(1.15, 1.55), P=0.000 2］,and reduced recurrence rate［RR=0.31, 95%CI(0.20, 0.47), P<0.000 01］. At the same time, serum albumin was significantly increased［RR=6.28, 95%CI(4.20, 8.36), P<0.000 01］, 24 h urine protein quantitation was significantly reduced RR=-1.05, 95%CI(-1.45, -0.64) ),P<0.000 01］, and the total cholesterol was also significantly decreased［RR= - 1.80, 95%CI(-2.46, - 1.15),P<0.000 01］.
Conclusion
Traditional Chinese medicine combined with cyclophosphamide is effective in the treatment of refractory nephrotic syndrome in children. It can increase the total effective rate and total cure rate, reduce the recurrence rate, and greatly improve the quality of life of children. However, the quality of the literature included in this study is low, and the above conclusions still need to be verified by more high-quality clinical trials.

Key words: Refractory nephrotic syndrome, Cyclophosphamide, Meta-analysis, Children