解毒凉血法联合西药治疗慢加急性肝衰竭Meta分析  

Meta-analysis of detoxication and cooling blood therapy combined with western medicine in the treatment of acute-on-chronic liver failure

作　　者：时克 黄云义 侯杰 王宪波[1] SHI Ke;HUANG Yun-yi;HOU Jie;WANG Xian-bo(Department of Integrated Chinese and Western Medicine,Beijing Ditan Hospital Affiliated to Capital Medical University,Beijing,100015,China)

机构地区：[1]首都医科大学附属北京地坛医院中西医结合中心,北京100015 [2]北京中医药大学第一临床医学院

出　　处：《中西医结合肝病杂志》2020年第6期537-540,558,共5页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：首都卫生发展科研专项基金(No.2018-1-2172);北京市科学技术委员会项目(No.Z19110000619033)。

摘　　要：目的:系统评价解毒凉血法联合西药治疗慢加急性肝衰竭的有效性和安全性。方法:计算机检索PubMed、Cochrane Library、中国知网、万方数据库、中国生物医学文献数据库、维普网,检索时间从各数据库建库至2019年11月,收集解毒凉血法治疗慢加急性肝衰竭的随机对照试验,对纳入的文献提取资料及质量评价,通过RevMan5.3软件对慢加急性肝衰竭患者的死亡率、显效率、凝血功能、肝功能等项进行Meta分析。结果:纳入13篇文献,共1191例患者,文献质量一般。Meta分析显示,解毒凉血法联合西药治疗慢加急性肝衰竭患者在降低死亡率[RR=0.50,95%CI(0.37,0.68),P<0.00001]、提高临床显效率[RR=1.57,95%CI(1.29,1.91),P<0.00001]、延长PTA[MD=16.82,95%CI(12.06,21.59),P<0.00001]、降低ALT[MD=-16.38,95%CI(-24.16,-8.60),P<0.0001]、降低TBil[MD=-67.11,95%CI(-91.32,-42.90),P<0.00001]等方面优于单纯西药治疗。结论:解毒凉血法联合西药治疗慢加急性肝衰竭,能明显改善患者肝功能和凝血功能,有效降低患者死亡率,提高显效率,具有临床推广应用价值。Objective:To evaluate the efficacy and safety of detoxification and cooling blood therapy combined with western medicine in the treatment of acute-on-chronic liver failure.Methods:Pubmed,Cochrane library,CNKI,Wanfang,CBM and VIP were searched for randomized controlled trials(RCTs)till November 2019 on detoxication and cooling blood therapy combined with Western medicine in the treatment of acute-on-chronic liver failure.Based on the data and quality evaluation of the included literature,the mortality,apparent efficiency,coagulation function and liver function of patients with acute-on-chronic liver failure were analyzed by Revman 5.3 software.Results:There were 13 articles included,1191 patients in total,and the quality of the articles included was average.Meta analysis showed that the combination of detoxification and cooling blood therapy with western medicine reduced mortality[RR=0.50,95%CI(0.37,0.68),P<0.00001],improved clinical efficiency[RR=1.57,95%CI(1.29,1.91),P<0.00001],prolonged PTA[MD=16.82,95%CI(12.06,21.59),P<0.00001],decreased ALT[MD=-16.38,95%CI(-24.16,-8.60),P<0.0001],and decreased TBIL[MD=-67.11,95%CI(-91.32,-42.90),P<0.00001]was better than western medicine alone.Conclusion:The method of detoxification and cooling blood combined with western medicine can effectively reduce the mortality,improve the apparent efficiency,improve the liver function and coagulation function,and has clinical application value.

关 键 词：慢加急性肝衰竭 解毒凉血法 西药 META分析 

分 类 号：R657.3[医药卫生—外科学]