中医药治疗非酒精性脂肪肝患者主要生化学指标变化的文献Meta分析

Meta-analysis of effect of TCM on main biochemical indexes of non-alcoholic fatty liver disease

目的:对中医药治疗非酒精性脂肪肝患者丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、γ-谷氨酰转移酶(GGT)、胆固醇(TC)、甘油三酯(TG)和高密度脂蛋白胆固醇(HDL-C)指标改善的有效性作出较客观的评估。方法:从中国生物医学文献数据库、中文科技期刊全文数据库和中国期刊全文数据库(1999-2008年),检索研究中医药对非酒精性脂肪肝ALT、AST、GGT、TC、TG和HDL-C水平影响的临床随机对照试验,采用RevMan4.2软件进行统计分析。结果:共11篇文献1078例患者符合纳入标准,所有试验质量普遍不高,未发现双盲试验。Meta分析显示与常规西药相比,中医药能明显升高HDL-C,降低ALT、AST、GGT、TC和TG。结论:以本项Meta分析为基础,中医药对非酒精性脂肪肝ALT、AST、GGT、TC、TG和HDL-C指标的改善较西医治疗有益。但由于纳入试验的质量不高,目前尚不能得出最终结论。

Objective： To make an impersonal evaluation on the effect of TCM on main biochemical indexes of non-alcoholic fatty liver disease （NAFLD）,including ALT,AST,GGT,TC,TG,and HDL-C.Methods： We searched all the randomized controlled trials （RCTs） of TCM for NAFLD from CBM, CNKI,and VIP （1999-2008）.RevMan4.2 was used in the analysis. Results： 11 RCTs,including 1078 patients,met the inclusion criteria.All of the trials were not adequate in methodological quality. None of them was double-blinded trial.The result of analysis showed that compared with basic Western medicine,TCM could increase the content of HDL-C,reduce the content of ALT,AST,GGT,TC and TG.Conclusion： The present meta-analysis suggested that TCM was beneficial over Western medicine for NAFLD which indexes including ALT,AST,GGT,TC,TG,and HDL-C.But we can not make a final conclusion due to low quality of RCT.