Rhubarb-based Chinese herbal formulae for hepatic encephalopa-thy:a systematic review and Meta-analysis  

作　　者：Zhang Ning Zhou Shuangnan Xiao Xiaohe Wanq Zhen Bai Yunfeng He Tingting Zhou Chao Wang Yao Kun Zhou Wang Zhongxia Liu Bing Larry J.Prokop Matthew C.Hernandez Li Jun Gong Man 

机构地区：[1]Center of Integrative Medicine,302 Military Hospital of China,Beijing 100039,China [2]Liver Transplantation Center,302 Mili-tary Hospital of China,Beijing 100039,China [3]Evidence-based Practice Center,Mayo Clinic,Rochester 55905,USA [4]Library Public Services,Mayo Clinic,Roch-ester 55905,USA [5]Division of Trauma,Critical Care,Department of Surgery,Mayo Clinic,Rochester 55905,USA

出　　处：《Journal of Traditional Chinese Medicine》2017年第6期721-734,共14页中医杂志（英文版）

基　　金：Supported by Major Projects of National Science and Technology:the Study of Optimal Regimen for Integrative Treatment of Acute-on-chronic Liver Failure(No.2017zx1020-5506-002);Special Scientific Projects from The State Administration of Traditional Chinese Medicine of The People'S Republic of China:the Study on the Mechanism of Chinese Herbs for Chronic Liver Failure Focused on the Signaling Pathway of Lps/tlr4(No.Jdzx2015187)

摘　　要：OBJECTIVE: To evaluate the effectiveness and safety of rhubarb-based Chinese herbal formulae(RCHF), which are widely used to treat hepatic encephalopathy(HE) in China.METHODS: Nine online databases were searched from inception to November 22, 2016. Eligible studies were randomized controlled trials of Traditional Chinese Medicine(TCM) treatment for adult patients(≥ 18 years old) with HE. Outcomes such as mortality rate, clinical response rate, blood ammonia level, and alanine aminotransferase were evaluated between TCM group and control group.RESULTS: Thirty studies involving 2661 HE patients were analyzed. Most studies used RCHF treatment.Compared with conventional treatment as usual,lactulose, and vinegar, RCHF were associated with significant improvement in clinical response rate[risk ratio(RR) = 1.33, 95% confidence interval(CI) =1.25, 1.43, I2= 0%; RR = 1.26, 95% CI = 1.14, 1.38, I2=22%; and RR = 1.19, 95% CI = 1.06, 1.33, I2= 0%, respectively] and significant reductions in levels of blood ammonia and alanine aminotransferase. Only minor RCHF-associated adverse events, such as abdominal pain(0.3%), anal tenesmus(0.3%), and diarrhea(2.3%), were reported, and there were no significant differences in these events between the treatment group and the three types of control group.CONCLUSION: The findings suggest that RCHF may be an alternative treatment option for HE patients. More rigorous multicenter studies with larger samples and longer observational periods are needed to confirm these findings.OBJECTIVE: To evaluate the effectiveness and safety of rhubarb-based Chinese herbal formulae(RCHF), which are widely used to treat hepatic encephalopathy(HE) in China.METHODS: Nine online databases were searched from inception to November 22, 2016. Eligible studies were randomized controlled trials of Traditional Chinese Medicine(TCM) treatment for adult patients(≥ 18 years old) with HE. Outcomes such as mortality rate, clinical response rate, blood ammonia level, and alanine aminotransferase were evaluated between TCM group and control group.RESULTS: Thirty studies involving 2661 HE patients were analyzed. Most studies used RCHF treatment.Compared with conventional treatment as usual,lactulose, and vinegar, RCHF were associated with significant improvement in clinical response rate[risk ratio(RR) = 1.33, 95% confidence interval(CI) =1.25, 1.43, I2= 0%; RR = 1.26, 95% CI = 1.14, 1.38, I2=22%; and RR = 1.19, 95% CI = 1.06, 1.33, I2= 0%, respectively] and significant reductions in levels of blood ammonia and alanine aminotransferase. Only minor RCHF-associated adverse events, such as abdominal pain(0.3%), anal tenesmus(0.3%), and diarrhea(2.3%), were reported, and there were no significant differences in these events between the treatment group and the three types of control group.CONCLUSION: The findings suggest that RCHF may be an alternative treatment option for HE patients. More rigorous multicenter studies with larger samples and longer observational periods are needed to confirm these findings.

关 键 词：Drugs  Chinese HERBAL RHEUM HEPATICENCEPHALOPATHY META-ANALYSIS Review 

分 类 号：R259[医药卫生—中西医结合]