水飞蓟宾治疗酒精性肝病疗效的Meta分析

The efficacy of sylibin in the treatment of patients with alcoholic liver disease:a Meta-analysis

目的：评价水飞蓟宾治疗酒精性肝病的疗效和安全性。方法检索Cochrane图书馆、PubMed、OVID、CNKI、维普和万方等数据库中水飞蓟宾治疗酒精性肝病的随机对照研究，收录时间为1998年至2013年；使用RevMan 5.0软件进行Meta分析。结果共纳入8个研究，包括849例酒精性肝病患者；水飞蓟宾治疗组综合疗效优于一般保肝药的对照组，其OR为5.49（95％CI 3.51～8.58，P＜0.00001）；治疗组与对照组比，ALT、AST和GGT的加权均数差（WMD）分别为-6.20（95%CI -9.06～3.35）、-14.17（95%CI-17.08～11.25）和-32.32（95%CI-36.83～27.81），凝血酶原时间和白蛋白的WMD分别为2.11（95%CI 0.64～3.57）和1.42（95%CI 0.08～2.75），总胆固醇和甘油三脂的WMD 分别为-1.40（95%CI -1.61～1.19）和-0.35（95%CI -0.56～0.13），提示治疗组肝酶学指标、合成功能指标和降低血脂方面均显著优于对照组（P均＜0.00001，）；治疗组不良反应发生率为0.8%，对照组为1.7%。结论水飞蓟宾可显著改善酒精性肝病患者生化指标，且无明显不良反应。

Objective To evaluate the efficacy and safety of sylibin in the treatment of patients with alco-holic liver disease（ALD）. Methods A systematic search of literatures in Cochrane Library,Pubmed,OVID,CNKI, VIP and Wanfang Database was performed,and randomized controlled trial （RCT） of silybin for ALD treatment were retrieved;RevMan 5.0 software was used for Meta-analysis. Results A total of 8 RCT trails involving 849 patients with ALD were included;The overall efficacy of silybin for ALD was better than that in the control group,with a OR-value of 5.49 （95%CI=3.51-8.58,P〈0.00001）;Between the silybin and the control group,the weighted mean differences（WMDs）for ALT,AST,and GGT were -6.20（95%CI -9.06 - -3.35）,-14.17（95% CI -17.08 - -11.25） and -32.32 （95% CI -36.83 - -27.81）,respectively,and the WMDs for PT and ALB were 2.11 （95%CI 0.64-3.57） and 1.42 （95% CI 0.08 - 2.75）,respectively,while WMDs for TC and TG were -1.40（95%CI -1.61 - -1.19）and -0.35 （95% CI -0.56 - -0.13）,respectively;The adverse effect rate in silybin group was 0.8%,while that in control group was 1.7%. Conclusion Silybin might be effective in improving liver function without clinically significant adverse effects in patients with ALD.