异甘草酸镁联合疗法治疗慢性乙型肝炎的效果及安全性的meta分析  

Meta-analysis of efficacy and safety of Magnesium Isoglycyrrhizinate combined therapy in the treatment of chronic hepatitis B

作　　者：曾雪亮[1] 钟文敏[1] 李蓓[1] ZENG Xue-liang;ZHONG Wen-min;LI Bei(Department of Pharmacy,the First Affiliated Hospital of Gannan Medical College,Jiangxi Province,Ganzhou 341000,China)

机构地区：[1]赣南医学院第一附属医院药学部,江西赣州341000

出　　处：《中国当代医药》2021年第30期13-17,共5页China Modern Medicine

基　　金：江西省卫生计生委科技计划(20175382)。

摘　　要：目的系统评价异甘草酸镁联合疗法治疗慢性乙型肝炎的疗效及安全性。方法检索中国生物医学文献数据库(CBM)、万方数据、中国知网(CNKI)、PubMed、和Cochrane Library从建库至2020年10月公开发表的文献,纳入异甘草酸镁联合疗法治疗慢性乙型肝炎的随机对照试验(RCT)研究。对纳入的文献筛查、提取资料及质量评价并采用Review Manager 5.3软件进行meta分析。结果最终纳入16篇RCT研究,共1932例患者,试验组979例,对照组953例。meta分析结果显示,试验组的总体疗效高于对照组,差异有统计学意义[OR=3.34,95%CI=(2.14,5.22),P<0.00001]。试验组丙氨酸氨基转移酶(ALT)水平、天冬氨酸氨基转移酶(AST)水平、总胆红素(TBil)水平降低比对照组更明显,ALT[MD=-17.26,95%CI=(-22.32,-12.21),P<0.00001],AST[MD=-13.62,95%CI=(-22.20,-5.03),P=0.002],TBil[MD=-4.80,95%CI=(-6.10,-3.51),P<0.00001]。试验组不良反应发生率低于对照组,差异有统计学意义[OR=0.54,95%CI=(0.32,0.91),P=0.02]。结论异甘草酸镁联合疗法可显著降低慢性乙型肝炎患者的ALT、AST及TBiL水平,且发生不良反应率低于单药疗法。Objective To systematically evaluate the efficacy and safety of Magnesium Isoglycyrrhizinate combined therapy in the treatment of chronic hepatitis B.Methods Literatures published in China Biology Medicine(CBM),Wanfang Data,China National Knowledge Infrastructure(CNKI),PubMed,and Cochrane Library from its establishment to October 2020 were searched,randomized controlled trials(RCT)of Magnesium Isoglycyrrhizinate combined therapy in the treatment of chronic hepatitis B was included.The included literatures were screened,extracted and evaluated for quality,and meta-analysis was performed using Review Manager 5.3 software.Results Sixteen RCT studies were included,including 1932 patients,979 in the experimental group and 953 in the control group.Meta-analysis results showed that the overall efficacy of the experimental group was higher than that of the control group,and the difference was statistically significant(OR=3.34,95%CI=[2.14,5.22],P<0.00001).The levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total bilirubin(TBil)in experimental group decreased more significantly than those in control group,ALT(MD=-17.26,95%CI=[-22.32,-12.21],P<0.00001),AST(MD=-13.62,95%CI=[-22.20,-5.03],P=0.002),TBil(MD=-4.80,95%CI=[-6.10,-3.51],P<0.00001).The incidence of adverse reactions in experimental group was lower than that in control group,and the difference was statistically significant(OR=0.54,95%CI=[0.32,0.91],P=0.02).Conclusion Magnesium Isoglycyrrhizinate combination therapy can significantly reduce the levels of ALT,AST and TBiL in chronic hepatitis B patients,and the adverse reaction rate is lower than that of monotherapy.

关 键 词：异甘草酸镁 联合疗法 慢性乙型肝炎 META分析 肝功能 

分 类 号：R512.6[医药卫生—内科学]