Astragalusin the Prevention of Upper Respiratory Tract Infection in Children with Nephrotic Syndrome: Evidence-Based Clinical Practice

Abstract

Aims. To explore whetherAstragalusor its formulations could prevent upper respiratory infection in children with nephrotic syndrome and how best to use it.Methods. We transformed a common clinical question in practice to an answerable question according to the PICO principle. Databases, including the Cochrane Library (Issue 5, 2012), PUBMED (1966–2012.8), CBM (1978–2012.8), VIP (1989–2012.8), and CNKI (1979–2012.8), were searched to identify Cochrane systematic reviews and clinical trials. Then, the quality of and recommendations from the clinical evidence were evaluated using the GRADEpro software.Results. The search yielded 537 papers. Only two studies with high validity were included for synthesis calculations. The results showed thatAstragalusgranules could effectively reduce URTI in children with nephrotic syndrome compared with prednisone treatment alone (23.9% versus 42.9%; RR = 0.56 and 95% CI = 0.33–0.93). The dose ofAstragalusgranules was 2.25 gram (equivalent to 15 gram crudeAstragalus) twice per day, at least for 3–6 months. The level of evidence quality was low, but we still recommended the evidence to the patient according to GRADEpro with the opinion of the expert. Followup showed the incidence of URTI in this child decreased significantly.Conclusions.Astragalusgranules may reduce the incidence of URTI in children with nephrotic syndrome.