祛瘀化痰法治疗非酒精性脂肪性肝病Meta分析  

Meta-Analysis of Dispelling Phlegm and Removing Stasis in the Treatment of Non-alcoholic Fatty Liver Disease

作　　者：石皓[1] 邓广辉 李允家 杨梦晗 叶海欣 高磊[1] SHI Hao;DENG Guanghui;LI Yunjia;YANG Menghan;YE Haixin;GAO Lei(School of Traditional Chinese Medicine,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学中医药学院,广东广州510515

出　　处：《山东中医杂志》2022年第3期281-289,共9页Shandong Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:81774170);广东省杰出青年科学基金项目(编号:2018B030306012)。

摘　　要：目的:系统评价祛瘀化痰法中药组方治疗非酒精性脂肪性肝病的临床疗效。方法:检索祛瘀化痰法治疗非酒精性脂肪性肝病的随机对照试验文献,进行文献筛选、资料提取及质量分析,使用RevMan 5.3软件对临床有效性、肝功能、血脂、肝/脾CT值等进行Meta分析。结果:最终纳入文献17篇,Meta分析表明,与对照组比较,祛瘀化痰法治疗非酒精性脂肪性肝病临床有效率提高[OR=2.87,95%CI(2.21,3.73),P<0.00001],患者丙氨酸转氨酶(ALT)水平降低[MD=-13.62,95%CI(-18.35,-8.89),P<0.00001],天冬氨酸转氨酶(AST)水平降低[MD=-15.42,95%CI(-20.48,-10.36),P<0.00001],总胆红素降低[MD=-11.07,95%CI(-19.20,-2.94),P=0.008],甘油三酯(TG)降低[MD=-0.53,95%CI(-0.72,-0.34),P<0.00001],总胆固醇(TC)降低[MD=-0.61,95%CI(-0.79,-0.43),P<0.00001],高密度脂蛋白胆固醇(HDL-C)升高[MD=0.19,95%CI(0.09,0.29),P<0.0001],低密度脂蛋白胆固醇(LDL-C)降低[MD=-0.31,95%CI(-0.60,-0.02),P=0.04],肝/脾CT值升高[MD=0.14,95%CI(0.06,0.23),P=0.001]。结论:祛瘀化痰法中药方可改善非酒精性脂肪性肝病患者肝功能、降低血脂,临床有效率高,较单一类型西药治疗有明显优势。Objective:To systematically evaluate the clinical efficacy of dispelling phlegm and removing stasis methods in the treatment of non-alcoholic fatty liver disease(NAFLD).Methods:Literature on randomized controlled trials(RCTs)of treating NAFLD with dispelling phlegm and removing stasis was searched.The included literature was screened to retrieve data and quality assessment was conducted.In the meta-analysis,RevMan 5.3 was used for evaluating clinical efficacy,liver function,blood lipid levels,and liver-spleen CT number difference.Results:Finally,17 RCTs were included.According to the meta-analysis,compared with the control group the clinical efficacy of treating NAFLD with dispelling phlegm and removing stasis was increased[OR=2.87,95%CI(2.21,3.73),P<0.00001],levels of alanine aminotransferase(ALT)decreased[MD=-13.62,95%CI(-18.35,-8.89),P<0.00001],levels of aspartate transaminase(AST)decreased[MD=-15.42,95%CI(-20.48,-10.36),P<0.00001],levels of total bilirubin(TB)decreased[MD=-11.07,95%CI(-19.20,-2.94),P=0.008],levels of triglyceride(TG)decreased[MD=-0.53,95%CI(-0.72,-0.34),P<0.00001],levels of total cholesterol(TC)decreased[MD=-0.61,95%CI(-0.79,-0.43),P<0.00001],levels of high density lipoprotein cholesterol(HDL-C)increased[MD=0.19,95%CI(0.09,0.29),P<0.0001],levels of low density lipoprotein cholesterol(LDL-C)decreased[MD=-0.31,95%CI(-0.60,-0.02),P=0.04],and liver-spleen CT number difference increased[MD=0.14,95%CI(0.06,0.23),P=0.001].Conclusion:Method of dispelling phlegm and removing blood stasis could improve liver function and reduce blood lipids in patients with NAFLD with high clinical efficacy compared with western medicine.

关 键 词：祛瘀化痰 非酒精性脂肪性肝病 META分析 肝功能 血脂 

分 类 号：R256.4[医药卫生—中医内科学]