美他多辛治疗酒精性肝病的meta分析  

Efficacy of metadoxine in treatment of alcoholic liver disease:a meta analysis

作　　者：李游 章燕虹 沈薇[1] 

机构地区：[1]重庆医科大学附属第二医院消化内科,重庆400010

出　　处：《现代医药卫生》2018年第2期181-185,共5页Journal of Modern Medicine & Health

摘　　要：目的系统评价美他多辛治疗酒精性肝病(ALD)的效果。方法检索Pub Med、Cochrane Library、MEDLINE、EMBASE、Web of Science、中国期刊网全文数据库(CNKI)、万方数据库,时间为从建库到2017年6月,纳入所有以中文/英文形式公开发表的美他多辛治疗ALD中应用的随机对照试验。采用Re VMan 5.3软件进行统计分析。结果共纳入10篇文献,meta分析结果显示美他多辛单用组及联合用药组在ALD患者中的总有效率、谷丙转氨酶降低量、谷草转氨酶降低量、谷氨酰转肽酶降低量、胆固醇降低量、三酰甘油降低量等结局指标差异均有统计学意义(P<0.05);在总胆红素降低量结局指标上,联合用药组有统计学意义(P<0.05),单用组无统计学意义(P>0.05)。重症酒精性肝炎患者中使用美他多辛联合其他阳性药物可显著降低近期死亡事件发生。结论美他多辛可改善ALD患者肝功能、总胆红素及血脂,降低重症酒精性肝炎患者的近期死亡事件,在ALD的治疗中具有一定的临床价值。Objective To systematically evaluate the efficacy of metadoxine in the treatment of alcoholic liver disease（ALD）. Methods The databases of Pub Med,Cochrane Library,MEDLINE,EMBASE,Web of Science,Chinese Journal Net Database（CNKI）,Wanfang database were retrieved to search the Chinese/English articles about the randomized controlled clinical trials（RCTs）in the application of metadoxine for treating ALD from their establishment to June 2017. The Rev Man5.3 software was adopted to conduct the analysis. Results A total of 10 atticles were included. The meta analysis results showed that the total effective rate,ALT decreasing amount,AST decreasing amount,GGT decreasing amount,cholesterol decreasing amount and triglyceride decreasing amount had statistical difference between the metadoxine single use group and combined medication group（P〈0.05）. The combined medication group had statistical significance in the outcome indicator of total bilirubin decreasing amount（P〈0.05）,while the metadoxine single use group had no statistical significance（P〉0.05）. Using metadoxine combined with other positive drugs in the patients with severe alcoholic hepatitis could significantly reduce the occurrence of recent death event. Conclusion Metadoxine can improve the liver function,total bilirubin and blood lipids in ALD patients,reduces the recent death event of the patients with severe alcoholic hepatitis,and has a certain clinical value in the treatment of ALD.

关 键 词：吡多辛 吡咯烷酮羧酸 肝疾病 酒精性 肝功能试验 META分析 

分 类 号：R575.5[医药卫生—消化系统]