大黄䗪虫丸联合恩替卡韦抗乙型肝炎性肝纤维化疗效的Meta分析

Meta-analysis of Dahuang Zhechong Pill Combined with Entecavir on the Efficacy of Hepatitis B Liver Fibrosis

目的:应用Meta分析评价大黄䗪虫丸联合恩替卡韦治疗乙型肝炎性肝纤维化的临床疗效、应用价值及研究方向。方法:检索数据库包括知网(CNKI)、万方(WANFANG)、维普(VIP)、中国生物医学数据库(CBM)、PubMed、The Cochrane Library、Embase。检索时间范围系自建库至2022年9月。挑选出大黄䗪虫丸联合恩替卡韦治疗乙型肝炎肝纤维化的随机对照试验(RCT),应用RevMan 5.3分析软件分析。结果:文献筛选结果显示,共有8个研究被纳入,包含690例患者,观察组和对照组各有347例和343例。Meta分析结果显示,大黄䗪虫和恩替卡韦两药联用组对于乙型肝炎性肝纤维化患者血清中透明质酸(HA)、层黏蛋白(LN)、Ⅲ型胶原(PCⅢ)、Ⅳ型胶原(Ⅳ-C)的改善效果优于单用恩替卡韦的对照组,除了Ⅳ型胶原(Ⅳ-C),其他三项标志物两组间差异均达到统计学显著性。结论:结果显示,大黄䗪虫丸联合恩替卡韦有良好的抗乙型肝炎性肝纤维化作用,表明大黄䗪虫丸具有抗乙型肝炎性肝纤维化作用或增强恩替卡韦抗乙型肝炎性肝纤维化作用,提示临床治疗乙型肝炎性肝纤维化时可考虑选用大黄䗪虫丸和恩替卡韦联合使用的治疗方案。

Objective We used Meta-analysis to evaluate the clinical efficacy,application value and research direct of Dahuang Zhechong pill combined with entecine in the treatment of hepatitis B liver fibrosis.Methods Searchable databases included CNKI,Wanfang,VIP,CBM,PubMed,The Cochrane Library,and Embase.The time range of the search was set as from the establishment of the database to September 2022 by us.We selected Randomized controlled trials,which were conducted to focus on the efficacy of Dahuang Zhechong pill combined with Entecavir versus Entecavir Monotherapy in the treatment of hepatitis B liver fibrosis.We used REVMAN 5.3 to analysis.Results Literature screening showed that a total of 8 studies were included,including 690 patients,347 in the observation group and 343 in the control group.The results of the Meta analysis showed that,the effect of combination of Dahuang Zhechong and Entecavir on serum hyaluronic acid(HA),Laminin(LN),typeⅢCollagen(PCⅢ)and typeⅣCollagen(Ⅳ-C)in patients with hepatitis B liver fibrosis was better than that of Entecavir alone,except typeⅣCollagen(Ⅳ-C),the other three markers showed statistically significant difference between the two groups.Conclusion The results showed that the combination of Dahuang Zhechong pill and Entecavir had good anti-hepatitis B liver fibrosis effect,the results showed that Dahuang Zhechong pill had anti-hepatitis B liver fibrosis effect or enhanced anti-hepatitis B liver fibrosis effect of Entecavir,it is suggested that the combination of Dahuang Zhechong pill and Entecavir should be considered in the clinical treatment of hepatitis B liver fibrosis.