芒硝敷脐治疗肝硬化腹水的Meta分析

Mirabilite umbilical compress in treatment of ascites in liver cirrhosis: a meta-analysis

目的系统评价芒硝敷脐治疗肝硬化腹水的疗效。方法从中国知网、维普、万方、Pub Med数据库检索有关芒硝敷脐治疗肝硬化腹水的文献。应用随机效应模型进行荟萃分析,组间连续性资料的比较结果应用标准化均数差(SMD)表达,组间分类性资料的比较结果应用优势比(OR)表达。结果共11项随机对照研究被纳入。与对照组相比,芒硝敷脐治疗组的腹水缓解率明显更高(OR=3.19,P<0.000 1),腹围(SMD=1.69,P<0.000 1)及体质量(SMD=2.77,P<0.000 1)降低程度更加明显。与治疗前相比,芒硝敷脐治疗后ALT水平明显降低(SMD=1.92,P=0.000 9),白蛋白水平明显增高(SMD=-1.78,P=0.000 6),但AST(SMD=2.14,P=0.056)及TBil(SMD=3.39,P=0.25)水平并未显著改变。结论芒硝敷脐对治疗肝硬化腹水有一定疗效,但对肝功能改善尚不确定。

Objective To systematically evaluate the efficacy of mirabilite umbilical compress in the treatment of ascites in liver cirrhosis.Methods The literature on the treatment of cirrhotic ascites with mirabilite umbilical compress was searched in CNKI,VIP,Wanfang Data,and Pub Med databases. A meta- analysis was carried out using the random effect model. The continuous and categorical data were expressed as aas standard mean difference（ SMD） and odds ratio（ OR）,respectively. Results A total of 11 randomized controlled trials were included. The mirabilite umbilical compress treatment group showed a significantly higher response rate of ascites（ OR = 3. 19,P〈0. 0001） and significantly reduced abdominal circumference（ SMD = 1. 69,P〈0. 0001） and body weight（ SMD = 2. 77,P〈0. 0001） compared with the control group. After mirabilite umbilical compress treatment,alanine transaminase level was significantly decreased（ SMD = 1. 92,P =0. 0009）,albumin level was significantly increased（ SMD =- 1. 78,P = 0. 0006）,while aspartate aminotransferase and total bilirubin levels showed no significant changes（ SMD = 3. 39,P = 0. 25）. Conclusion Mirabilite umbilical compress is effective in the treatment of ascites in liver cirrhosis,yet its efficacy in improving liver function remains uncertain.