六味五灵片联合恩替卡韦治疗慢性乙型肝炎肝硬化的Meta分析  

Meta-analysis of Liuweiw uling Tablet combined with entecavir in the treatment of chronic hepatitis B cirrhosis

作　　者：章方玲 吴和霏 王建[1] 黄立华[1] 马骁[1] ZHANG Fang-ling;WU He-fei;WANG Jian;HUANG Li-hua;MA Xiao(School of Pharmacy,Chengdu University of Traditional Chinese Medicine,Key Laboratory of Standardization for Chinese Herbal Medicine,Ministry of Education,National Key Laboratory Breeding Base of Systematic Research,Development and Uilization of Chinese Medicine Resources,Chengdu 611137 Sichuan)

机构地区：[1]成都中医药大学药学院,中药材标准化教育部重点实验室,四川省中药资源系统研究与开发利用重点实验室--省部共建国家重点实验室培育基地,四川成都611137

出　　处：《中药与临床》2020年第6期44-53,共10页Pharmacy and Clinics of Chinese Materia Medica

基　　金：四川省科技厅应用基础项目(2019YJ0492);北京医卫健康公益基金会资助项目(B20645FN);成都中医药大学杏林学者学科人才科研提升计划(QNXZ2018025);成都中医药大学中药学科特色创新科研团队(CXTD2018004)。

摘　　要：目的:基于荟萃分析(Meta分析)方法,对六味五灵片联合恩替卡韦治疗慢性乙型肝炎肝硬化的有效性进行系统评价。方法:计算机检索七个中英文数据库(中国知网,维普数据库,万方数据库,中国生物医学文献数据库,PubMed,Embase,Cochrane library),纳入六味五灵片联合恩替卡韦治疗慢性乙型肝炎肝硬化的随机对照实验(观察组患者使用六味五灵片联合恩替卡韦,对照组患者使用恩替卡韦)。进行文献质量评估后,运用RevMan5.3软件进行数据分析。结果:最终纳入8篇文献,共计912例慢性乙型肝炎肝硬化患者。Meta分析结果显示:在谷丙转氨酶(ALT)、谷草转氨酶(AST)、层粘连蛋白(LN)、Ⅳ型胶原(Ⅳ-C)、Ⅲ型前胶原(PC-Ⅲ)等肝功能指标、肝纤维化指标变化上,不同疗程的观察组均明显优于对照组(P<0.05);同时观察组总有效率、HBV DNA转阴率均明显高于对照组(P<0.05);观察组脾厚度较对照组显著降低(P<0.05)。当疗程≤6个月时,观察组可显著降低总胆红素(TBIL)水平(P<0.05),但两组患者血清白蛋白(ALB)、透明质酸酶(HA)水平差异无统计学意义(P>0.05)。当疗程>6个月时,观察组ALB、HA水平明显优于对照组(P<0.05),但两组患者TBIL水平差异无统计学意义(P>0.05)。两组患者凝血酶原活动度(PTA)水平、HBeAg转阴率、门脉主干内径、门脉最大流速无明显差异(P>0.05)。结论:与单纯使用恩替卡韦治疗相比,六味五灵片联合恩替卡韦治疗慢性乙型肝炎肝硬化临床疗效更优。Objective:Based on meta-analysis,the efficacy of Liuweiwuling Tablet combined with entecavir in the treatment of chronic hepatitis B cirrhosis was systematically evaluated.Method:Seven Chinese and English databases(CNKI,VIP,Wanfang,CBM,PubMed,Embase,Cochrane library) were searched by computer to collect the clinical randomized controlled trial of Liuweiwuling tablet combined with entecavir in the treatment of chronic hepatitis B cirrhosis(the treatment group were treated with Liuweiwuling tablet combined with entecavir,while the control group were treated with entecavir).RevMan5.3 software was used to analyze data after literature quality assessment.Result:8 randomized controlled trial were included,involving 912 patients with chronic hepatitis B and liver cirrhosis.Meta-analysis results showed that the change of partial liver function indicators and liver fibrosis indicators,that is,alanine aminotransferase,aspertate aminotransferase,laminin,type Ⅳ collagen and type III procollagen,in treatment group with different treatment courses was significantly better than control group(P <0.05).Meanwhile,total efficiency rate and negative conversion ratio of HBV DNA in treatment group were significantly higher than those in control group(P <0.05).The spleen thickness in treatment group was significantly lower than that in control group(P <0.05).When the course was equal to or less than six months,the treatment can significantly reduce total bilirubin(TBIL) level(P <0.05),but no significant difference(P> 0.05) was observed in the levels of albumin(ALB),hyaluronidase(HA) between two groups.When treatment was longer than six months,ALB and HA levels of treatment group were obviously higher than those in control group(P <0.05),but no statistical significance was observed in TBIL level between two groups(P> 0.05).There was no significant difference in prothrombin activity,HBeAg negative conversion rate,inner diameter of portal trunk and maximum portal velocity between two groups(P> 0.05).Conclusion:Liuweiwuling Tablet combin

关 键 词：六味五灵片 恩替卡韦 慢性乙型肝炎 肝硬化 META分析 

分 类 号：R287[医药卫生—中药学]