双环醇治疗抗结核药致肝损害疗效的Meta分析

Protective effect of bicyclol on anti-tuberculosis drug-induced hepatotoxicity: a Meta-analysis

目的评价双环醇治疗抗结核致肝损伤的有效性。方法计算机检索中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)、万方数据库、维普数据库、以及PUBMED、EMbase、Central数据库等。根据纳入标准和排除标准筛选所需要的随机对照试验(randomized controlled trial,RCT)研究。然后,提取资料,通过Stata11.0软件进行Meta分析。结果本研究共纳入7篇文献,研究对象有1 847人,其中治疗组有998人,对照组有849人。Meta分析结果为:(1)试验组的肝功能改善总有效率高于对照组(RR=1.277,95%CI:1.082~1.506,P=0.004);(2)亚组分析:2周内试验组的肝功能改善总有效率高于对照组(RR=1.224,95%CI:1.128~1.329,I2=0.0%,P=0.579);4周内试验组的肝功能改善总有效率也高于对照组(RR=1.337,95%CI:0.862~2.074,I2=97.4%,P<0.001);(3)2组间不良反应发生率无明显差异(RR=0.921,95%CI:0.483~1.938,P=0.828)。结论双环对抗结核致肝损伤患者的具有良好的治疗效果。

Objective To evaluate the efficacy of bicyclol in the treatment of anti-tuberculosis drug-induced hepatotoxieity. Methods Data related to the efficacy of bicyclol in the treatment of anti-tuberculosis drug-induced liver injury were searched from databases including CBM, CNKI, WanFang, VIP Data, PUBMED, EMbase, Central, etc. The randomized controlled trials （RCT） were chosen based on the inclusion and exclusion criteria. Meta-analysis was performed using Stata 11.0 software. Results A total of 1 847 patients from 9 ramdomized controlled trial （RCT） were included, of which 998 were test cases and 849 were control cases. The meta-analysis results showed that the total effective rate of liver function improvement was higher in bicyclol group than that in control group （RR = 1. 277,95% CI： 1. 082-1. 506, P = 0. 004）. What＇ s more, subgroup analysis showed that the total effective rate of the improvement of liver function within 2 weeks in the experimental group was better than that in control group （RR = 1. 224,95 % CI： 1. 128-1. 329,12 = 0. 0% , P = 0. 579） ; the total effective rate of the improvement of liver function within 4 weeks in the test group was significantly higher than that in control group （ RR = 1. 337,95 % CI： 0. 862-2. 074, I^2 = 97.4%, P 〈 0. 001 ）. Finally, there was no significant difference between two groups in side effect （RR = 0. 921,95% CI：0. 483-1. 938,P =0. 828）. Conclusions Bieyelol is effective in improving liver injury induced by anti-tuberculosis drugs in tuberculosis （TB） patients.