解毒化瘀法治疗肝衰竭临床疗效的Meta分析  

Meta-Analysis of the Clinical Efficacy of Detoxification and Removing Blood Stasis Therapy in the Treatment of Hepatic Failure

作　　者：甘子华 雷成君 吕超 张荣臻[2] 

机构地区：[1]灵山县中医医院,广西灵山535400 [2]广西中医药大学第一附属医院,广西南宁530023

出　　处：《大众科技》2021年第12期29-34,共6页Popular Science & Technology

基　　金：国家自然科学基金资助项目(81560752,81960841);广西壮族自治区自然科学基金资助面上项目(2018GXNSFAA281096);广西壮族自治区科技计划项目(桂科AD17129001);广西壮族自治区创新研究团队项目(2018GXNSFGA281002);2020年广西中医药大学引进博士科研启动基金项目(2020BS028);2020年广西中医药大学第一附属医院院级博士科研启动基金项目(2020BS005)。

摘　　要：目的:系统评价解毒化瘀法或治疗肝衰竭的临床疗效。方法:全面检索截至2021年6月的PubMed、万方、维普、知网、中国生物医学文献数据库中有关解毒化瘀法或治疗肝衰竭的随机、对照试验,提取相关文献资料后,对纳入研究进行质量评估和有效数据提取,最后运用RevMan 5.3软件对有效率、谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBiL)、凝血酶原活动度(PTA)、白蛋白(ALB)、血氨浓度(NH3)、MELD进行Meta分析。结果:18个纳入研究共涉及1440例患者,Meta分析结果显示:治疗组总有效率高于对照组,[RR=1.35,95%CI(1.24,1.46),P<0.00001];ALT水平,[SMD=-0.93,95%CI(-1.18,-0.68),P<0.00001];AST水平,[SMD=-0.74,95%CI(-1.07,-0.42),P<0.00001];TBiL水平,[SMD=-0.93,95%CI(-1.18,-0.68),P<0.00001];PTA水平,[SMD=0.96,95%CI(0.71,1.21),P<0.00001]。结论:解毒化瘀法或治疗肝衰竭疗效显著,改善患者的临床指标,可为临床决策提供依据,但由于纳入研究的方法学质量普遍较低,该结论仍需更多高质量的临床试验进一步支持。Objective:To systematically evaluate the clinical effect of detoxification and removing blood stasis therapy or treating liver failure.Methods:The randomized and controlled trials on detoxification and stasis removal or treatment of liver failure in PubMed,Wanfang,VIP,CNKI and China biomedical literature database up to June 2021 were comprehensively searched.After extracting the relevant literature,the quality evaluation and effective data extraction of the included studies were carried out.Finally,the effective rate,alanine aminotransferase(ALT)and Aspartate aminotransferase(AST),total bilirubin(TBiL),prothrombin activity(PTA),albumin(ALB),blood ammonia concentration(NH3)and meld were analyzed by Meta-analysis.Results:18 included studies involved 1440 patients,the results of Meta-analysis showed that the total effective rate of the treatment group was higher than that of the control group,[RR=1.35,95%C I(1.24,1.26,1.46),P<0.00001];ALT level,[SMD=-0.93,95%CI(-1.18,-0.68),P<0.00001];AST level,[SMD=-0.74,95%CI(-1.07,-0.42),P<0.00001];TBiL level,[SMD=-0.93,95%CI(-1.18,-0.68),P<0.00001];PTA level,[SMD=0.96,95%CI(0.71,1.21),P<0.00001].Conclusion:Detoxification and emoving blood stasis therapy or treatment of liver failure has significant curative effect,improves the clinical indicators of patients,and can provide basis for clinical decision-making.However,due to the generally low quality of methodology included in the study,this conclusion still needs more high-quality clinical trials to further support.

关 键 词：肝衰竭 解毒化瘀法 系统评价 随机对照试验 META分析 

分 类 号：R575[医药卫生—消化系统]