五苓散加减治疗非酒精性脂肪性肝炎的Meta分析

Meta-analysis of Wuling powder in treating non-alcoholic fatty liver disease

目的:系统评价五苓散加减治疗非酒精性脂肪性肝炎(NASH)的临床疗效。方法:计算机检索PubMed、The Web of Science、Embase、Cochrane Library、CNKI等中英文数据库,收集五苓散加减联合常规疗法治疗NASH的随机对照试验,对纳入文献进行质量评估和资料提取,采用RevMan 5.3软件进行Meta分析。结果:最终纳入12项RCT,总样本量为1126例患者。Meta分析结果显示:五苓散加减联合常规疗法提高了NASH的治疗疗效[OR=2.64,95%CI:(2.53,5.57),P<0.001]、治疗后患者血清丙氨酸转移酶(ALT)水平下降[SMD=-1.99,95%CI:(-2.15,-1.83),P<0.001]、血清天冬氨酸转移(AST)水平下降[SMD=-1.63,95%CI:(-1.79,-1.47),P<0.001]、总胆固醇(TC)水平下降[SMD=-0.96,95%CI:(-1.12,-0.79),P<0.001]、甘油三酯(TG)水平下降[MD=-0.30,95%CI(-0.32,-0.28),P<0.001]。结论:五苓散加减联合常规疗法可明显改善NASH患者的肝功能,降低血脂水平,提高临床治疗总有效率。

Objective:To evaluate the clinical effect of Wuling powder in patients with non-alcoholic fatty liver disease.Methods:PubMed,Web of Science,Embase,Cochrane Library,and CNKI were searched systematically and comprehensively.Included in the published Randomized Controlled Trials(RCTs)of Wu-ling powder in the treatment of Non-alcoholic Fatty Liver Disease(NASH)in combination with conventional medicine before December 2019.The quality evaluation and data extraction of the literature were carried out and then analyzed by Revman 5.3 software.The outcome measures included liver function,blood lipid level,and total effective rate of treatment.Results:The results of meta-analysis showed that the therapeutic effect of Wuling powder plus control group on nonalcoholic fatty liver disease was better than that of control group[OR=2.64,95%CI:(2.53,5.57),P<0.00001],ALT[SMD=-1.99,95%CI:(-2.15,-1.83),P<0.00001],AST[SMD=-1.63,95%CI:(-1.79,-1.47),P<0.00001],TC[SMD=-0.96,95%CI:(-1.12,-0.79),P<0.00001],TG[MD=-0.30,95%CI:(-0.32,-0.28),P<0.00001].Conclusion:Wuling powder can significantly improve the liver function in NASH patients,reduce the level of blood lipids,and improve the total clinical efficiency.