熊去氧胆酸治疗脂肪性肝病疗效的Meta分析  

Meta-analysis of randomized controlled trials of ursodeoxycholic acid in treatment of fatty liver disease

作　　者：朱卫民[1] 唐小红[1] 

机构地区：[1]重庆医科大学附属第一医院感染科,400016

出　　处：《肝脏》2014年第10期736-740,共5页Chinese Hepatology

摘　　要：目的：评估熊去氧胆酸治疗脂肪性肝病的疗效。方法本研究为文献的二次研究设计。采用 Cochrane系统综述方法，按预先制定的检索策略，在PubMed、Embase、HighWire Press、中国生物医学文献数据库、维普中文科技期刊数据库、中国知网数据库及万方数据库等电子文献数据库中检索1994年至2013年发表的相关文献。制定纳入标准对文献进行筛选以保证纳入研究的同质性，由2名评价者独立评价所纳入研究的质量，提取资料并交叉核对。对纳入的文献采用修改过的Jadad量表进行质量评价，符合标准的研究采用RevMan 5．1软件进行Meta分析，对异质性研究先行描述性分析，以比值比（OR）表示效应指标。结果①共检索到符合纳入标准的相关文献24篇，纳入分析的患者共2334例，其中熊去氧胆酸治疗组1166例，对照组1168例，随访时间1～6个月。②Meta分析结果提示：熊去氧胆酸能有效治疗脂肪性肝病（OR＝1．73，95％ CI为1．01～2．95；Z＝2．01，P＜0．05）；对治疗组单用熊去氧胆酸治疗进行亚组分析，治疗组较对照组差异有统计学意义（P＜0．01）；对治疗组在对照组治疗基础上加用熊去氧胆酸药物治疗进行亚组分析，治疗组较对照组差异也有统计学意义（P＜0．01）。结论熊去氧胆酸治疗脂肪性肝病有效率较高。Objective To systematically evaluate the efficacy of ursodeoxycholic acid in treatment of fatty liver disease. Methods Meta-analysis was adopted in this study. According to prescribed strategy,retrieval of electronic bibliographic databases （PubMed,Embase,HighWire Press,CBLD,VIP,CNKI,Wanfang Data and so on）published from 1994 to 2013 were conducted by Cochrane systematic review. Implement standards for literature selection were used to ensure homogeneity of research. Two reviewers evaluated quality of included studies and extracted data,independently. At last,literature was incorporated by modified Jadad quality assessment scale and analyszed by RevMan 5.1 software. With odds ratio （OR）value as effect index,randomized effect model was used to analyze clinical heterogeneity. Results A total of 24 randomized controlled trials （RCTs）involved 2 334 patients with fatty liver diseases,including 1 166 patients treated with ursodeoxycholic acid and 1168 patients treated with other drugs matched inclusion criteria. Follow-up period lasted for 1 month to 6 months. Meta-analysis indicated that the total effective rate （OR）was 1 .73 with the 95% confidence interval（CI） 1.01-2.95,and significant difference was found between experimental and control groups （Z= 2.01,P= 0.04）. By subgroup for further analysis,compared with control group,treatment of ursodeoxycholic acid or a combination of ursodeoxycholic acid and other drugs in experimental group was significantly effective,with significant differences （P〈0.01）. Conclusion Ursodeoxycholic acid is a highly effective drug in treatment with fatty liver disease.

关 键 词：META分析 熊去氧胆酸 脂肪肝 

分 类 号：R575.5[医药卫生—消化系统]