实脾饮治疗肝硬变腹水Meta分析

A Meta Analysis of Spleen-Strengthening Decoction in the Treatment of Ascites due to Cirrhosis

目的:系统评价实脾饮治疗肝硬变腹水的临床疗效。方法:计算机检索PubMed、The Cochrane Library、EMbase、中国知网、万方数据库、维普中文期刊数据库等数据库,收集实脾饮治疗肝硬变腹水的随机对照试验(randomized controlled trial,RCT),提取相关数据,并采用Cochrane 5.1.0软件对文献质量进行评价,采用Stata14进行Meta分析。结果:纳入RCT文献12篇,共1 007例患者。Meta分析结果显示,治疗组有效率高于对照组[RR=1.27,95%CI(1.16,1.38),P=0.00]。治疗组在降低体质量[WMD=-11.513,95%CI(-6.429,-3.509),P=0.00]、腹围[WMD=-9.560,95%CI(-14.17,-4.95),P=0.00]、丙氨酸氨基转移酶[WMD=-11.513,95%CI(-14.58,-8.77),P=0.00]、天冬氨酸氨基转移酶[WMD=-14.119,95%CI(-16.348,-11.809),P=0.00]、症状积分[WMD=-2.805,95%CI(-3.909,-1.702),P=0.00],升高白蛋白[WMD=6.263,95%CI(4.57,7.96),P=0.00]和24 h尿量[WMD=-2.805,95%CI(-3.909,-1.702),P=0.00]等方面优于对照组,差异具有统计学意义(P<0.05)。结论:实脾饮治疗肝硬变腹水疗效优于常规疗法,但因纳入研究的数量和质量有限,上述结论有待高质量的RCT验证,今后需进行大样本、高质量、多中心的临床RCT研究。

Objective:To systematically evaluate the clinical efficacy of Spleen-Strengthening Decoction in the treatment of ascites due to cirrhosis.Methods:PubMed,the Cochrane Library,EMBASE,CNKI,Wanfang database,VIP database and other databases were searched to collect randomized controlled trials(RCTs) of Spleen-Strengthening Decoction in the treatment of ascites due to cirrhosis,and relevant data were extracted.The quality of literature was evaluated by Cochrane 5.1.0 software,and a Meta-analysis was performed by stata14.Results:A total of 12 RCTs involving 1,007 patients were included.The Meta analysis showed that the effective rate of the treatment group was higher than that of the control group [RR=1.27,95%CI(1.16,1.38),P=0.00].In the treatment group,the body mass [WMD=-11.513,95%CI(-6.429,-3.509),P=0.00],abdominal circumference [WMD=-9.560,95%CI(-14.17,-4.95),P=0.00],alanine aminotransferase [WMD=-11.513,95%CI(-14.58,-8.77),P=0.00],aspartate aminotransferase [WMD=-14.119,95%CI(-16.348,-11.809),P=0.00],symptom score [WMD=-2.805,95%CI(-3.909,-1.702),P=0.00],the increased albumin [WMD=6.263,95%CI(4.57,7.96),P=0.00] and 24 h urine volume [WMD=-2.805,95%CI(-3.909,-1.702),P=0.00] in the treatment group were better than those in the control group,and all the differences were statistically significant(P<0.05).Conclusion:The therapeutic effect of Spleen-Strengthening Decoction on ascites due to cirrhosis is better than that of conventional therapy.However,due to the limited number and quality of included studies,the above conclusions need to be verified by high-quality RCTs,and large sample,high-quality,multi-center clinical RCTs′ study is needed in the future.