小柴胡汤联合恩替卡韦治疗慢性乙型病毒性肝炎的Meta分析

Meta Analysis of Xiaochaihu Decoction and Entecavir in the Treatment of Chronic Hepatitis B

目的:系统评价小柴胡汤联合恩替卡韦治疗慢性乙型肝炎(chronic hepatitis B,CHB)的有效性,为临床治疗提供循证参考。方法:计算机检索7个中英文数据库,筛选小柴胡汤联合恩替卡韦治疗慢性乙型肝炎的随机对照研究(randomized controlled trial,RCT),对其进行质量评价及资料提取,并采用Re-view Manager 5.3进行Meta分析。结果:共纳入10项RCT,共875例,包括治疗组437例,对照组438例。治疗组血清ALT复常率(RR=1.29,95%CI[1.18,1.44],P<0.00001),血清HBeAg转阴率(RR=2.27,95%CI[1.68,3.08],P<0.00001),血清HBV-DNA转阴率(RR=2.40,95%CI[1.73,3.33],P<0.00001),临床疗效(RR=5.88,95%CI[3.48,9.93],P<0.00001),应答率(RR=2.08,95%CI[1.47,2.97],P<0.0001),以上指标治疗组均优于对照组。结论:小柴胡汤联合恩替卡韦治疗CHB,能有效改善患者肝功生化复常率,提高血清HBeAg及HBV DNA转阴率,其临床疗效及应答率明显提高。

Objective:To systematically assess the efficacy of Xiaochaihu decoction combined with entec avir in treating CHB,so as to provide the evidence-based reference for clinical therapy.Methods:RCT about Xiaochaihu decoction and entecavir in treating CHB was screened in seven Chinese and English databases using computer,to perform the qualty evaluation and data extraction,Review Manager 5.3 was used to perform Meta analysis.Results:All ten RCTs were included,involving 875 cases,including 437 cases of the treatment group and 438 cases of the control group.The results showed that the normalization rate of serum ALT of the treatment group was(RR=1.29,95%CI[1.18,1.44],P<0.00001),serum HBeAg negative conversion rate(RR=2.27,95%CI[1.68,3.08],P<0.00001),serum HBV-DNA negative conversion rate(RR=2.40,95%CI[1.73,3.33],P<0.00001),clinical effects(RR=5.88,95%CI[3.48,9.93],P<0.00001),response rate(RR=2.08,95%CI[1.47,2.97],P<0.00001),the treatment group was better than the control group in the indexes above.Conclusion:Xiaochaihu decoction combined with entecavir in treating CHB could effectively improve biochemical normalization rate of liver function,lift serum HBeAg negative conversion rate and HBV-DNA negative conversion rate,its clinical effects and response rate significantly.