微生态制剂治疗非酒精性脂肪性肝病疗效的meta分析

Efficacy of microecologics in treating nonalcoholic fatty liver disease:a meta-analysis

目的系统评价微生态制剂治疗非酒精性脂肪性肝病(NAFLD)的效果。方法检索Pub Med、Wiley Inter Science、Springer Link、MEDLINE、EMBASE、Web of Science所有以英文形式发表的关于微生态制剂在NAFLD中应用的随机对照试验。应用Review Manager5.3软件进行数据分析。结果应用微生态制剂可显著降低NAFLD患者丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、胰岛素抵抗指数(HOMA-IR)、总胆固醇(TC)、低密度脂蛋白(LDL)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)水平,加权均数差分别为-20.49[95%可信区间(95%CI):-30.20^-10.78,P<0.000 10]、-24.52(95%CI:-34.58^-14.46,P<0.000 01)、-0.38(95%CI:-0.52^-0.23,P<0.000 01)、-0.32(95%CI:-0.56^-0.07,P=0.010 00)、-0.45(95%CI:-0.72^-0.19,P=0.000 70)、-0.47(95%CI:-0.88^-0.06,P=0.030 00)、-1.51(95%CI:-2.29^-0.73,P=0.000 20)。微生态制剂的应用不能明显改善患者体质量指数、三酰甘油水平,加权均数差分别为-1.31(95%CI:-2.86~0.23,P=0.100 00)、-0.19(95%CI:-0.49~0.11,P=0.230 00)。结论微生态制剂可有效降低NAFLD患者ALT、AST、TC、LDL、TNF-α、CRP水平,减轻患者胰岛素抵抗,在NAFLD的治疗中具有一定的临床应用价值。

Objective To systematically evaluate the efficacy of microecologics in the treatment of nonalcoholic fatty liver disease（NAFLD）. Methods The randomized controlled trials（RCTs）on the efficacy of microecologics in the treatment of NAFLD in English were retrieved from the databases of Pub Med,Wiley Inter Scienc,Springer Link,MEDLINE,EMBASE and Web of Science. The obtained data were analyzed by the Review manager 5.3 software. Results Microecologics could significantly decrease the levels of serum ALT,AST,homeostasis model assessment of the insulin resistance（HOMA-IR）,TC,LDL,TNF-α and CRP in the NAFLD patients,and the weighted mean differences（WMDs） were-20.49（95%CI：-30.20--10.78,P〈0.000 10）,-24.52（95%CI：-34.58--14.46,P0.000 01）,-0.38（95%CI：-0.52--0.23,P0.000 01）,-0.32（95%CI：-0.56--0.07,P=0.010 00）,-0.45（95%CI：-0.72--0.19,P=0.000 70）,-0.47（95%CI：-0.88--0.06,P=0.030 00）,-1.51（95%CI：-2.29--0.73,P=0.000 20） respectively. Microecologics could not improve the level of BMI and TG obviously,WMD was-1.31（95%CI：-2.86-0.23,P=0.100 00）,-0.19（95%CI：-0.49 -0.11,P =0.230 00）respectively. Conclusion Microecologics is effective in decreasing the levels of serum ALT,AST,HOMA-IR,TC,LDL,TNF-α and CRP in NAFLD patients,alleviates the insulin resistance and has certain clinical application value in the treatment of NAFLD.