肝爽颗粒治疗肝损伤有效性和安全性的系统评价与Meta分析

Systematic review and Meta-analysis of efficacy and safety of Ganshuang Granules in treatment of liver injury

对肝爽颗粒治疗肝损伤的有效性和安全性进行系统评价,为肝损伤患者提供新的选择。系统检索中国知网(CNKI)、万方(Wanfang)、中国生物医学文献服务系统(SinoMed)、维普(VIP)、PubMed、EMbase、Cochrane Library、Web of Science,筛选出肝爽颗粒治疗肝损伤的随机对照试验(RCT),并根据Cochrane Handbook 5.1评价标准和工具、RevMan 5.4软件对最终纳入的研究进行Meta分析。最终纳入38项RCTs,总样本量3 005例,试验组1 536例,对照组1 469例。Meta分析结果显示,肝爽颗粒+西医常规可有效降低肝损伤患者的谷丙转氨酶(ALT)(MD=-24.12,95%CI[-32.17,-16.07],P<0.000 01)、谷草转氨酶(AST)(MD=-23.24,95%CI[-29.70,-16.78],P<0.000 01)、总胆红素(TBiL)(MD=-12.42,95%CI[-14.62,-10.22],P<0.000 01)、谷氨酰转肽酶(GGT)(MD=-21.32,95%CI[-33.61,-9.03],P=0.000 7)的水平,提高白蛋白(ALB)的水平(MD=4.94,95%CI[4.44,5.45],P<0.000 01),无显著的不良反应。基于现有数据和方法,肝爽颗粒+西医常规可有效改善肝损伤患者的ALT、AST、TBiL、GGT、ALB等水平,但仍需开展高质量的RCT对该研究结果进行验证。

This study systematically evaluated the efficacy and safety of Ganshuang Granules in the treatment of liver injury, so as to provide a new choice for patients with liver injury. CNKI, Wanfang, VIP, SinoMed, Cochrane Library, PubMed, EMbase, and Web of Science were systematically searched for the randomized controlled trial(RCT) of Ganshuang Granules in the treatment of liver injury. RevMan 5.4 was employed to perform the Meta-analysis of the included RCT according to the Cochrane Handbook 5.1. A total of 3 005 patients were included in 38 RCTs, including 1 536 patients in the observation group and 1 469 in the control group. The results of Meta-analysis showed that Ganshuang Granules combined with conventional therapy was superior to the therapy in the control group in reducing alanine aminotransferase(ALT)(MD=-24.12, 95%CI[-32.17,-16.07], P<0.000 01), aspartate aminotransferase(AST)(MD=-23.24, 95%CI[-29.70,-16.78], P<0.000 01), total bilirubin(TBiL)(MD=-12.42, 95%CI[-14.62,-10.22], P<0.000 01), and gamma-glutamyl transpeptidase(GGT)(MD=-21.32, 95%CI[-33.61,-9.03], P=0.000 7). Compared with the control group, the observation group had witnessed a significant increase in albumin(ALB)(MD=4.94, 95%CI[4.44, 5.45], P<0.000 01). No significant adverse reactions were observed. According to the available data, Ganshuang Granules combined with conventional therapy can effectively recover the levels of ALT, AST, TBiL, GGT, and ALB in patients with liver injury. Nevertheless, high-quality RCT is still needed to further verify the findings of this study.