中成药联合熊去氧胆酸治疗原发性胆汁性胆管炎疗效的Meta分析  

Meta Analysis of Chinese Patent Medicine Combined with Ursodeoxycholic Acid in Treatment of Patients with Primary Biliary Cholangitis

作　　者：时桢 郑玥琪[1] 陈逸云[1] 徐黎[1] 陈建杰[1] SHI Zhen;ZHENG Yue-qi;CHEN Yi-yun;XU Li;CHEN Jian-jie(Shuguang Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200021,China)

机构地区：[1]上海中医药大学附属曙光医院

出　　处：《中医药导报》2019年第23期88-92,共5页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家中医药管理局重点学科（中医传染病学科）（2010）;陈建杰上海市名中医工作室（ZYSNXD-CC-MZY003）

摘　　要：目的:评价中成药联合熊去氧胆酸治疗原发性胆汁性胆管炎的有效性。方法:计算机检索Cochrane Library、PubMed、中国期刊全文数据库(CNKI)、中文科技期刊全文数据库(VIP)、万方学术期刊全文数据库、中国生物医学文献服务系统(SinoMed),自建库至2018年8月31日正式发表的文献。根据纳入标准和排除标准选择文献,对纳入的文献进行质量评价和提取相关性研究指标,应用RevMan 5.3软件对数据进行Meta分析。结果:共纳入16项RCT研究,共计1133例患者,其中治疗组568例,对照组565例。Meta分析结果显示:中成药联合熊去氧胆酸(UDCA)治疗原发性胆汁性胆管炎在提高临床总有效率[RR=1.13,95%CI(1.06,1.20),P<0.05]、改善肝功能(TBIL、ALP、GGT、ALT、AST、ALB)、血清肝纤维化指标(PCⅢ、HA、IV-C、LN)、免疫学指标(IgM、IgG)及临床症状方面均优于单用UDCA(P<0.05)。两组肝脏弹性硬度值比较,差异无统计学意义(P>0.05)。结论:中成药联合UDCA治疗原发性胆汁性胆管炎的疗效优于单用UDCA治疗,但纳入的研究方法学质量不高。Objective:To evaluate the effectiveness and the safety of Chinese patent medicine combined with ursodeoxycholic acid(UDCA)in treatment of patients with primary biliary cholangitis(PBC).Methods:The randomized controlled trials(RCT)articles on combination of Chinese patent medicine and UDCA in treatment of patients with PBC were retrieved from the Cochrane Library,PubMed,China national knowledge infrastructure(CNKI),Vip journal database(VIP),Wanfang academic journal database,SinoMed to the end of August 31,2018 by Cochrane systemic review method and materials were analyzed by Revman 5.3 software.Results:A total of 1133 patients were included in 16 randomized controlled trials,including 568 patients in the treatment group and 565 patients in the control group.The results of meta analysis showed that the application of Chinese patent medicine combined with ursodeoxycholic acid(UDCA)can increased the effectiveness rate[RR=1.13,95%CI(1.06,1.20),P<0.05]and it shows better effect than control group on biochemical indices of liver function(TBIL,ALP,GGT,ALT,AST and ALB),hepatic fibrosis(PCⅢ,HA,IV-C and LN),immunological indices(IgM and IgG)and clinical symptoms(P<0.05).There were no significant differences between the two groups in the liver stiffness measurement.Conclusion:Chinese patent medicine combined with UDCA in treatment of patients with PBC is promising,but the studies needs more evidences to prove it.

关 键 词：原发性胆汁性胆管炎 中成药 熊去氧胆酸 META分析 

分 类 号：R259[医药卫生—中西医结合]