鳖甲煎丸联合恩替卡韦治疗乙型肝炎肝硬化疗效Meta分析

Efficacy of Biejia Jianwan combined with entecavir for chronic hepatitis B cirrhosis:a Meta-analysis

目的:评价鳖甲煎丸联合恩替卡韦治疗乙型肝炎肝硬化的临床疗效。方法:检索国内外常用中英文数据库,搜集有关鳖甲煎丸治疗乙型肝炎肝硬化的临床随机对照试验(RCT)。两位评价员独立筛取文献、纳入基本信息,并对纳入研究进行质量评价和偏倚风险评估后,用RevMan 5.3软件进行Meta分析。结果:本研究纳入13个RCT,总计1068例患者,其中5个为高质量研究,其余8个为低质量。Meta分析结果显示,鳖甲煎丸联合治疗组的血清肝功能即AIT、AST、ALB的改善显著优于单用恩替卡韦组。鳖甲煎丸联合治疗组的血清肝纤维化水平显著低于单用恩替卡韦组。鳖甲煎丸联合治疗组不增加药物的不良反应。结论:与单用恩替卡韦相比,鳖甲煎丸联合治疗乙型肝炎肝硬化疗效较好,可显著改善乙型肝炎肝硬化患者血清肝功能、降低肝纤维化四项水平,且无显著不良反应。但受纳入RCT数量及质量的影响,上述结论尚需更多高质量的RCT予以验证。

Objective:To systematically review the clinical efficacy of treatment with Biejia Jianwan combined with entecavir chronic hepatitis B cirrhosis.Methods:The common Chinese and English databases were searched by computer,and the RCT of Biejia Jianwan in the treatment of chronic hepatitis B cirrhosis was collected.The two evaluators independently screened the literature and included the basic information.After the quality evaluation and bias risk assessment of the included study,used Revman 5.3 software for Meta analysis.Results:13 RCTs were included in the study,a total of 1068 patients,5 of which were high-quality studies,and the other 8 were low-quality studies.The results of Meta analysis showed that the improvement of serum liver function(AIT,AST,ALB)in Biejia Jianwan combined treatment group was significantly better than that of entecavir alone.The level of serum liver fibrosis in the combined treatment group was significantly lower than that of entecavir alone.The adverse reactions of Biejia Jianwan combined therapy group did not increase.Conclusion:Compared with entecavir alone,combined with Biejia Jianwan has better effect in the treatment of chronic hepatitis B cirrhosis.It can significantly improve the serum liver function and reduce the four levels of liver fibrosis in patients with chronic hepatitis B cirrhosis,and has no significant adverse reactions.However,affected by the quantity and quality of RCTs,the above conclusions need to be verified by more high-quality RCTs.