多烯磷脂酰胆碱联合还原型谷胱甘肽治疗酒精性肝病疗效的Meta分析  

Meta-analysis of the efficacy of polyene phosphatidylcholine combined with reduced glutathione in the treatment of alcoholic liver disease

作　　者：陈序 杨涛铧 陈观源 李震东[1] Chen Xu(Department of Hepatobiliary Surgery,The First Affiliated Hospital of Jinan University,Guangzhou 51000,China)

机构地区：[1]暨南大学附属第一医院(广州市华侨医院)肝胆外科,广东广州51000

出　　处：《牡丹江医学院学报》2023年第5期117-123,共7页Journal of Mudanjiang Medical University

基　　金：暨南大学附属第一医院临床研究项目(2018008)。

摘　　要：目的该研究旨在评估护肝药物多烯磷脂酰胆碱与还原型谷酰甘肽共同使用对酒精性肝病的治疗效果,通过开展Meta分析系统评估。方法在本次研究中,我们使用了多个数据库进行检索,设定检索时间为数据库建库时间至今。最终纳入15篇研究,共1401例患者。其中,实验组患者使用多烯磷脂酰胆碱和还原型谷胱甘肽联合用药处理,而对照组患者使用两种药物的其中一种处理,然后用RevMan 5.4软件对临床总有效率、肝功能相关指标和不良反应发生率进行荟萃分析。结果结果显示实验组(多烯磷脂酰胆碱联合使用还原型谷胱甘肽)用在治疗酒精性肝病的总有效率方面显著优于对照组(RR=1.21,95%CI:1.15~1.26,P<0.00001),同时能明显降低AST(MD=-26.42,95%CI:-30.57~-22.28,P<0.00001)、ALT(MD=-25.00,95%CI:-29.06~-20.94,P<0.00001)、TBiL(MD=-20.72,95%CI:-28.16~-13.29,P<0.00001)和γ-GT水平(MD=-40.99,95%CI:-48.49~-33.49,P<0.00001),并减少不良反应发生情况(RR=0.33,95%CI:0.17~0.64,P=0.009)。结论联合使用多烯磷脂酰胆碱与还原型谷胱甘肽有望在一定程度上提高酒精性肝病的药物治疗效果。Objective The aim of this study was to evaluate the efficacy of the combination of polyene phosphatidylcholine and reduced glutathione in the treatment of alcoholic liver disease through a systematic meta-analysis.Methods In this study,we used multiple databases for search and set the search time as the database construction time up to now.Finally,15 studies with a total of 1401 patients were included.Patients in the experimental group were treated with a combination of polyene phosphatidylcholine and reduced glutathione,while patients in the control group were treated with one of the two drugs.The total clinical response rate,liver function related indicators,and incidence of adverse reactions were then meta-analyzed using RevMan 5.4 software.Results The results showed that the experimental group(polyene phosphatidylcholine combined with reduced glutathione)was significantly better than the control group in the overall response rate for the treatment of ALD(RR=1.21,95%CI:1.15~1.26,P<0.00001).At the same time,the AST(MD=-26.42,95%CI:-30.57~-22.28,P<0.00001)、ALT(MD=-25.00,95%CI:-29.06~-20.94,P<0.00001)、TBiL(MD=-20.72,95%CI:-28.16~-13.29,P<0.00001)、γ-GT(MD=-40.99,95%CI:-48.49~-33.49,P<0.00001),occurrence of adverse reactions(RR=0.33,95%CI:0.17~0.64,P=0.009)can be significantly reduced.Conclusion The total effective rate of polyene phosphatidylcholine combined with reduced glutathione in the treatment of alcoholic liver disease is expected to improve the therapeutic effect of alcoholic liver disease to a certain extent.

关 键 词：酒精性肝病 多烯磷脂酰胆碱 还原型谷胱甘肽 META分析 有效性 

分 类 号：R575.5[医药卫生—消化系统]