保肝抗炎治疗慢性丙型肝炎疗效的Meta分析

Meta Analysis of Hepatoprotective Anti-Inflammatory Treatment of Chronic Hepatitis C

目的:系统评价保肝抗炎治疗慢性丙型肝炎的有效性,以期为临床用药提供参考。方法:计算机检索Cochrane Library、PubMed、中国期刊全文数据库(CNKI)、中文科技期刊全文数据库(VIP)、中国生物医学文献数据库(CBM)、万方医药期刊论文及学位论文数据库,纳入保肝抗炎治疗慢性丙型肝炎的随机对照试验(RCT),对纳入研究进行Jadad质量评分,对同质性结果进行合并分析。结果:纳入11项RCT,合计1 030例患者,其中高质量研究7篇。Meta分析结果显示,治疗组与对照组在降低丙氨酸转氨酶(ALT)复常率[P=0.03<0.05,WMD=-10.94,95%CI(-20.92,-0.97)]、天冬氨酸转氨酶(AST)的复常率[P<0.000 1,WMD=-10.45,95%CI(-15.32,-5.57)]方面比较差异有统计学意义,在改善血清总胆红素(TBIL)[P=0.74>0.05,WMD=-0.75,95%CI(-5.09,3.59)]和HCV-RNA转阴率[P=0.47>0.05,OR=2.01,95%CI(0.30,13.29)]方面治疗组与对照组比较差异无统计学意义。结论:保肝抗炎对治疗慢性丙型肝炎有一定的疗效而且相对安全无明显的不良反应。

Objective：To systematically evaluate the efficacy of the hepatoprotective anti-inflammatory treatment of chronic hepatitis C,in order to provide a reference for clinical treatment.Methods：Computer retrieval of Cochrane Library,PubMed,China National Knowledge Internet（CNKI）,Chinese Scientific Journals Full-text Database（VIP）,Chinese Biomedical Literature Database（CBM）,Wanfang medical journal papers and dissertations database,inclusion the randomized controlled trial（RCT） of hepatoprotective anti-inflammatory treatment of chronic hepatitis C,and Jadad quality score was applied to included studies,and the combined analysis of the homogeneity of the results.Results：11 RCTs,a total of 1030 patients,including 7 articles of high quality research.Meta-analysis results showed that difference of decrease alanine aminotransferase（ALT） normalization rates[P=0.030.05,WMD=-10.94,95%CI（-20.92,-0.97）],aspartate aminotransferase（AST） normalization rates[P0.000 1,WMD=-10.45,95%CI（-15.32,-5.57） ]of the two groups had statistical significance;Comparisons of improving serum total bilirubin（TBIL）[P=0.740.05,WMD=-0.75,95% CI（-5.09,3.59）] and HCV-RNA negative conversion ratio of the two groups[P=0.470.05,OR=2.01,95%CI（0.30,13.29）] showed that the difference was not statistically significant.Conclusion：Hepatoprotective anti-inflammatory for the treatment of chronic hepatitis C has certain curative effect,and relative safety with no obvious adverse reactions.