异甘草酸镁联合核苷类似物治疗慢性乙型肝炎的荟萃分析

Meta-analysis of magnesium isoglycyrrhizinate combined with nudeoside analogues in patients with chronichepatitis B

目的根据现有临床研究资料及结果评价异甘草酸镁联合核苷类似物渝宁陵性乙型肝炎的疗效及安全性。方法从1995至2013年中国生物医学光盘数据库和中国期刊网数据库，监索异甘草酸镁联合核苷类似物治疗慢性乙型肝炎的研究文献，并对相关研究进行荟萃分析。计量资料选用加权均数差值（WMD），计数资料采用Peto方法进行统计学分析。结果共6项随机对照试验（RCT）704例患者^选。Meta分析结果显示：ALIT：WMD=-12．98，其9蹴可信区间为-18．24～-7．71，尸〈0．01IAST：WMD=-9．49，其95％可信区间为-14．53～-4．45，P=0．0002IHBeAg：RR=1．79，其95％可信区间为1．17～2．76，P=0．008lHBVDNA：RR=1．35，其95％可信区间为1．05～1．74，P=0．02；异甘草酸镁联合核苷类似物治疗J慢性乙型肝炎的疗效显著优于单用核苷类似物，两组比较，差异有统计学意义伊〈0．01）。结论异甘草酸镁与核苷类似物联合治疗可促进肝功能恢复和提高抗病毒疗效。

Objective To evaluate the efficacy and safety of the magnesium isoglycyrrhizinate plus nuclenside analogues （MGL ＋ NA） combination therapy in patients with chronic hepatitis B using a recta-analysis approach. Methods The Chinese Biochemical htaature on Disc （CBMDisc） and the Chinese Scientific Joumal database, CNKI, were searched for randomized controlled trials （RCTs） of MGL＋NA in patients with chronic hepatitis B published between 1995 and 2013. Data related to treatment type （combination therapy vs. mono- therapy） and outcome （markers of efficacy and safety, including levels of hepatitis B virus （HBV） DNA, hepatitis B e antigen （HBeAg）, alanine aminotransferase （ALT） and aspartate aminotmnsferase （AST））. Weighted mean differences （WMD） were calculated and the Peto method was used to determine the relative risk （RR）, both with 95% confidence intervals （CIs）. Results Meta-analysis of the six included RCTs of MGL ＋ NA, representing a 704 patients with chronic hepatitis B, showed WMDs for ALT of-12.98 （95% CI： -18.24 - -7.71, P 〈 0.01） and for AST of-9.49 （95% C1：-14.53 ~ -4.45,P = 0.0002） and RRs for I-IBeAg of 1.79 （95% C1：1.17 ~ 2.76,P = 0.008） and for HBV DNA of 1.35 （95% C1：1.05 ~ 1.74,P = 0.02）. The therapeutic efficacy of MGL＋NA combination therapy was better than that of NA mono-thempy （P 〈 0.01）. Conclusion For patients with chronic hepatitis B, MGL combination therapy may enhance the antiviral efficacy of NA treatment and help to improve liver function during treatment.