基于温阳化瘀拟方治疗肝衰竭疗效及安全性Meta分析  

Meta Analysis of the Efficacy and Safety of Wenyang Huayu Decoction in the Treatment of Liver Failure

作　　者：卢昌林 刘美燕 陈炳东 黄小桃 梅梦如 刘志芳 曹音[1] 毛德文[2] 龙富立[2] Lu Changlin;Liu Meiyan;Chen Bingdong;Huang Xiaotao;Mei Mengru;Liu Zhifang;Cao Yin;Mao Dewen;Long Fuli(Guangxi University of Chinese Medicine,Nanning 530023,China;The First Hospital Affiliated to Guangxi University of Chinese Medicine,Nanning 530023,China)

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

出　　处：《亚太传统医药》2024年第6期181-187,共7页Asia-Pacific Traditional Medicine

基　　金：国家自然科学基金项目(82260907、82260899、82274434);广西科技计划项目(2020gXNSFAA297098、2020gXNSFAA297205、2020gXNSFAA297206、桂科AB22035076、2018GXNSFGA281002);广西中医药适宜技术开发与推广项目(GZSY23-30);广西中医药大学“桂派中医药传承创新团队”资助项目(2022A001)。

摘　　要：目的:旨在评估采用温阳化瘀拟方治疗肝衰竭患者的临床疗效及安全性。方法:全面检索建库至2023年7月30日的中国知网、万方数据库、维普网、中华医学期刊全文数据库、读秀、预印本平台、中医药科研数据库、PubMed、Web of Science、Clinic Trial等数据库中采用温阳化瘀拟方治疗肝衰竭的RCTs,而后通过纳排标准筛选符合要求的文献,对纳入文献质量评估后,组织研究者进行相关数据提取,最后运用RevMan 5.4软件对临床有效率、肝功能(丙氨酸氨基转移酶、门冬氨酸氨基转移酶、总胆红素、白蛋白)、凝血功能(凝血酶原时间、凝血酶原活动度)及中医证候评分、MELD评分、病死率进行Meta分析。结果:温阳化瘀拟方组在临床有效率[RR=1.38,95%CI(1.27,1.50),P<0.000 01]、丙氨酸氨基转移酶[MD=-18.06,95%CI(-22.55,-13.58),P<0.000 01]、门冬氨酸氨基转移酶[MD=-17.35,95%CI(-22.87,-11.82),P<0.000 01]、总胆红素[MD=-53.03,95%CI(-71.03,-35.02),P<0.000 01]、凝血酶原时间[MD=-3.81,95%CI(-4.85,-2.77),P<0.000 01]、凝血酶原活动度[MD=8.80,95%CI(5.84,11.77),P<0.000 01]、白蛋白[MD=3.49,95%CI(1.97,5.01),P<0.000 01]、MELD评分[MD=-2.65,95%CI(-3.81,-1.50),P<0.000 01]、中医证候评分[MD=-3.87,95%CI(-5.00,-2.75),P<0.000 01]、病死率[RR=0.51,95%CI(0.34,0.74),P=0.0005]方面均优于对照组,差异具有统计学意义(P<0.05)。结论:温阳化瘀拟方治疗肝衰竭疗效优于单纯西医综合治疗,可以改善患者临床症状及相应指标。Objective:The purpose of this study was to evaluate the clinical efficacy and safety of Wenyang Huayu prescription in the treatment of patients with liver failure.Methods:Searched the RCTs of treating liver failure with Wenyang Huayu Decoction in CNKI,WanFang Database,VIP,Chinese Medical Journal full-text database,Duxiu,preprint platform,TCM research database,PubMed,Web of Science,Clinic Trial and other databases as of July 30,2023.Then,the literature meeting the requirements is screened by the exclusion criteria.After the quality assessment of the included literature,the researchers are organized to extract relevant data.Finally,RevMan 5.4 software was used to conduct meta-analysis on clinical effective rate,liver function(alanine aminotransferase,aspartate aminotransferase,total bilirubin,albumin),coagulation function(prothrombin time,prothrombin activity),TCM syndrome score,MELD score,and fatality rate.Results:Clinical effective rate of Wenyang Huayu Decoction group [RR=1.38,95%CI(1.27,1.50),P<0.000 01],alanine aminotransferase [MD=-18.06,95%CI(-22.55,-13.58),P<0.000 01],aspartate aminotransferase [MD=-17.35,95%CI(-22.87,-11.82),P<0.000 01],total bilirubin [MD=-53.03,95%CI(-71.03,-35.02),P<0.000 01],prothrombin time [MD=-3.81,95%CI(-4.85,-2.77),P<0.000 01],prothrombin activity [MD=8.80,95%CI(5.84,11.77),P<0.000 01],albumin [MD=3.49,95%CI(1.97,5.01),P<0.000 01],MELD score [MD=-2.65,95%CI(-3.81,-1.50),P<0.000 01],TCM syndrome score [MD=-3.87,95%CI(-5.00,-2.75),P<0.000 01],mortality [RR=0.51,95%CI(0.34,0.74),P=0.0005]were better than the control group,and the difference was statistically significant(P<0.05).Conclusion:The effect of Wenyang Huayu Decoction on liver failure is better than that of Western medicine,which can improve the clinical symptoms and corresponding indexes of patients.

关 键 词：肝衰竭 温阳化瘀 临床疗效 随机对照试验 META分析 

分 类 号：R256.4[医药卫生—中医内科学]