甘利欣联合复方丹参治疗肝纤维化的系统评价

A systematic review of diammonium glycyrrhizinate with complex Danshen in treating hepatic fibrosis

目的:系统评价甘利欣联合复方丹参治疗肝纤维化的疗效。方法:计算机检索PubMed、EMBASE、Cochrane Library、CBM、CNKI和VIP等数据库,并辅手工检索和其他检索。收集有关甘利欣联合复方丹参与甘利欣或复方丹参比较治疗肝纤维化的随机对照试验和/或半随机对照试验,由两名研究者独立依据Handbook4.2.6推荐的方法评价纳入研究的文献质量,对符合纳入标准的研究采用RevMan4.2.10进行Meta分析。共纳入9个研究(1016例病人)。结果:①甘利欣联合复方丹参与复方丹参比较:在病人症状和体征的改善,抗肝纤维化指标(透明质酸酶、层粘蛋白、III型前胶原、IV-C型胶原)等方面的差异有统计学意义;②甘利欣联合复方丹参与甘利欣比较:在病人症状和体征的改善,抗肝纤维化指标(透明质酸酶、层粘蛋白、III型前胶原、IV-C型胶原、丙氨酸转氨酶)等方面的差异有统计学意义。结论:甘利欣联合复方丹参的抗肝纤维化作用优于甘利欣和复方丹参组,并可使代偿期肝硬化在一定程度上逆转,且不良反应少,由于目前的研究质量较低,尚需开展高质量临床试验的进一步证实。

Objective：To assess the effectiveness of diammonium glycyrrhizinate with complex Danshen for hepatic fibrosis. Methods： We searched PubMed, EMBASE, The Cochrane Library, Chinese Biomedical Literature Database, China Journal Fulltext Database, Chinese Scientific Journals Fulltext Database et al, conference proceedings, and references of the included studies, conference information and internet information. Randomized controlled trials of diammonium glycyrrhizinate with complex Danshen for hepatic fibrosis versus d/ammonium gly- cyrrhizinate or complex Danshen were included, we evaluated the quality of the included studies by Handbook 4.2.6 recommend standard and analyzed data by Cochrane Collaboration h RevMan 4.2. 10. Results：We included nine studies （included 1016 samples）. The results showed that there were difference diammonium glycyrrhizinate with complex Danshen for hepatic fibrosis versus diammonium glycyrrhizinate or complex Danshen in symptoms and physical sign of patient and index of anti - hepatic fibrosis which include hyaluronidase, laminin, Ⅲ precollagen,Ⅳ- C collogen and alanine aminotransferase. Conclnsions：Available evidence showed that ：diammonium glycyrrhizinate with complex Danshen was more effective than diammonium glycyrrbizinate or complex Danshen, and can some extent reverse compensatory cirrho- sis which has less adverse reaction. More high quality trims were needed to confirm the role of glycyrrhizinate with complex Danshen for he- patic fibrosis due to low quality researches at present.