复方甘草酸苷治疗妊娠合并慢性乙型肝炎905例Meta分析

Stronger neo-minophagen C treatment for pregnant patients with chronic hepatitis B:a Meta-analysis

目的系统评价复方甘草酸苷(stronger neo-minophagen C,SNMC)治疗妊娠合并慢性乙型肝炎(乙肝)的疗效与安全性。方法计算机检索PubMed、The Cochrane Library(2017年第4期)、CNKI、VIP、Wanfang data数据库,时间从建库至2017年5月,纳入SNMC治疗妊娠合并慢性乙肝的随机对照试验(randomized controlled trial,RCT)或自身前后对照研究。两名研究者独立筛选文献并提取资料。采用Revman 5.2软件进行Meta分析。结果纳入12篇文献,共905例患者。其中RCT 6篇,自身前后对照研究6篇。Meta分析显示:SNMC可提高疗效(RR=1.45,95%CI:1.26~1.66),改善患者肝功能ALT(SMD=-3.46,95%CI:-4.71^-2.21)、AST(SMD=-4.17,95%CI:-5.63^-2.71)、TBil(SMD=-1.39,95%CI:-1.90^-0.88),差异有统计学意义。SNMC治疗妊娠合并慢性乙肝无明显不良反应。结论 SNMC治疗妊娠合并慢性乙型肝炎有较好的疗效,但受纳入文献质量影响,上述结论仍需要设计严谨的大样本RCT来验证。

Objective To compare the efficacy and safety of stronger neo-minophagen C（SNMC）in the treatment of chronic hepatitis B in pregnant patients. Methods We searched PubMed,The Cochrane Library（Issue 4,2017）,CNKI,VIP and WanFang data up to May,2017 to identify randomized controlled trials（RCTs）or beforeafter self-controlled studies.Two investigators independently assessed the risk of bias and extracted data from the included studies.Meta-analyses were performed using Revman 5.2 software. Results A total of 905 patients from six RCTs and six before-after self-controlled studies were included in the analysis.The results of Meta-analyses showed that SNMC improved efficacy（RR=1.45,95% CI：1.26~1.66）compared with control group and improved hepatic functions of the patients by significantly reducing ALT（SMD=-3.46,95%CI：-4.71,-2.21）,AST（SMD=-4.17,95% CI：-5.63^-2.71）and TBiL（SMD=-1.39,95% CI：-1.90,-0.88）.There is no obvious adverse reactions in the treatment of patients with chronic hepatitis B in pregnant patients. Conclusions Stronger neo-minophagen C（SNMC）demonstrated its effectiveness on improving efficacy and hepatic functions in the treatment of pregnant patients with chronic hepatitis B.However,due to the restrictions by the quality of some included studies,the results still need to be verified by strictly designed and large sample RCT.