中药治疗非酒精性脂肪肝病临床研究的系统评价和有效成分筛选

Systematic review of treating nonalcoholic fatty liver with taking TCM and Screening of active components

目的系统评价中药治疗非酒精性脂肪肝病的有效性和安全性,对重要药味的有效成分进行筛选。方法检索6个数据库中关于中药治疗非酒精性脂肪肝病的临床随机对照试验的文献,时限均为自1990年1月—2013年7月。由两位评价员独立地根据预定的纳入标准筛选合格的文献,提取资料并交叉核对。统一采用Jaded质量记分法对纳入文献进行质量评价。采用Cochrane协作网提供的Revman5.2.0软件对纳入文献进行meta分析,用漏斗图进行发表性偏移的分析,从治疗方中遴选出使用频率较高的药味,分析中药降脂的有效活性成分。结果共纳入10篇文献,1395例患者,经质量评价其中4篇为高质量研究,其余6篇为低质量研究。Meta分析结果显示:中药治疗组总有效率优于西药或安慰剂治疗组,差异有统计学意义,P<0.01,RR=1.51(95%CI:1.41 to 1.62)。中药治疗非酒精性脂肪肝病的安全性较高。结论中药治疗非酒精性脂肪肝病疗效显著、安全性较好。

Objective To systematic review the clinical effectiveness and safety of Traditional Chinese medicine （TCM） for nonal-coholic fatty liver disease （NAFLD） and to screen effective herbs and active components. Methods We searched the papers of clinical randomized controlled trials of treating NAFLD by TCM in six databases （from the date of January 1990 to July 2013）.Ac-cording to the predetermined inclusion criteria, two estimators screening the papers, abstracted the information and checked across independently. Evaluating the literature quality by Jaded＇s score scale and judging the effectiveness by the software of Revman5.2.0 provided by the Cochrane network. The publication bias was studied by funnel plot analysis. Fifteen herbs used fre-quently were selected in the ten complex prescriptions, and their effective extracts were identified by bibliographic database. Re-sults There were ten literatures with 1395 cases included, of which 4 were of high quality and 6 of low quality. The results of Meta analyses showed： taking TCM could treat NAFLD more effectively than control groups in terms of the total effective rate and with-out serious adverse reactions. Conclusion The TCM on treatment of NAFLD has significant effects without serious side effects.