干扰素联合中药对慢性乙型肝炎肝纤维化的作用系统评价

Effect of interferon combined with traditional Chinese medicine on chronic hepatitis B-related liver fibrosis

目的:用Meta分析方法系统评价干扰素联合中药对慢性乙型肝炎肝纤维化的疗效。方法:计算机检索中文数据库:中国知网、万方数据系统、维普数据库、中国生物医学文献系统、中国博士学位论文全文数据库;外文数据库:Pubmed、Springer;同时辅以手工检索,检索时间自建库至2014年,共纳入文献13篇,采用RevMan 5.2软件进行荟萃分析。结果:13个有关干扰素联合中药治疗慢性乙型肝炎肝纤维化RCT研究共1109例患者纳入系统评价。Meta分析显示:干扰素联合中药治疗后患者肝功能指标ALT、AST、TB1L的MD/OR及95%C1分别为-25.87(-32.81,-18.92),-15.26(-23.17,-7.35),-3.22(-5.75,-0.69),P值均<0.01;肝纤维化指标HA、LN、PⅢP的MD/OR及95%C1分别为-49.63(-79.31,-19.95),-44.30(-66.87,-21.72),-57.19(-83.95,-30.42),P值均<0.01;病毒学指标HBeAg血清转换率、HBV-DNA阴转率的MD/OR及95%C1分别为1.80(1.24,2.60),1.68(1.15,2.45),P值均<0.01。与对照组比较,肝功能指标、肝纤维化指标、病毒学指标差异均有统计学意义,表明联合用药优于单用干扰素组。结论:干扰素联合中药组与单用干扰素组相比,患者肝功能与肝纤维化程度及病毒学指标均有明显改善。干扰素联合中药不仅能改善患者肝功能与肝纤维化情况,而且能提高抗病毒效果。

Objective：To evaluate the efficacy of interferon combined with traditional Chinese medicine in the treatment of chronic hepatitis B-related liver fibrosis by using Meta analysis method.Methods;computer searched Chinese databases;CNKI,Wanfang Data,VIP database,Chinese biomedical literature system,Chinese doctoral dissertations full text database;foreign language database;PubMed,Springer;At the same time,suing manual retrieval supplementary,The retrieval time from setting up databases to 2014,a total of 13 articles were included,Revman 5.2 software was used for meta-analysis.Results;13 cases of chronic hepatitis B-related liver fibrosis RCT study were included in the systematic review of 1109 patients.Meta analysis showed that the liver function MD/OR and 95%confidence interval（CI）were;ALT-25.87（-32.81,-18.92）,AST-15.26（-23.17,-7.35）,TBIL-3.22（-5.75,-0.69）（P〈0.01）;liver fibrosis index MD/OR and 95%confidence interval（CI） were HA-49.63（-79.31,- 19.95）,LN-44.30（-66.87,-21.72）,PⅢP-57.19（-83.95,-30.42）（P〈0.01）;HBeAg serum conversion rate and HBV-DNA negative conversion rate index MD/OR and 95%confidence interval（CI） were 1.80（1.24,2.60） and 1.68（1.15,2.45）（p0.01）.Compared with the control group,the difference of liver function,liver fibrosis index and Index of virus were statistically significant,which indicated that the combination therapy was better than that of single interferon group.Conclusion;the liver function,the degree of liver fibrosis and the index of virus were significandy improved in the combination of interferon and Chinese medicine.Interferon combined with traditional Chinese medicine can not only improve liver function and liver fibrosis in patients,but also improve the antiviral effect.