鳖甲煎丸联合替诺福韦治疗乙型肝炎的系统评价  

Systematic Review of Biejiajian Pills Combined with Tenofovir in the Treatment of Hepatitis B

作　　者：谭万芳 李国焕 谢旭 田伟平 TAN Wanfang;LI Guohuan;XIE Xu;TIAN Weiping(Dept.of Infectious Diseases,Zhuhai Hospital of Integrated Chinese and Western Medicine,Guangdong Zhuhai 519000,China)

机构地区：[1]珠海市中西医结合医院感染科,广东珠海519000

出　　处：《中国医院用药评价与分析》2025年第1期85-88,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：广东省中医药局科研项目(No.20232161)。

摘　　要：目的:探讨鳖甲煎丸联合替诺福韦治疗乙型肝炎的疗效。方法:计算机检索中国知网、中国生物医学文献数据库、万方数据库和维普数据库,搜集鳖甲煎丸联合替诺福韦对比单纯使用替诺福韦治疗乙型肝炎的随机对照试验(RCT),检索时限均为建库至2024年2月。由2名研究人员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.4软件进行Meta分析。结果:共纳入3项RCT,涉及326例研究对象。Meta分析结果显示,与单纯使用替诺福韦比较,鳖甲煎丸联合替诺福韦在降低全因死亡率、肝癌发生率和乙型肝炎病毒DNA转阴率方面没有显著效果,但对于改善肝脏纤维化指标血清透明质酸、Ⅳ型胶原水平,以及肝功能指标丙氨酸转氨酶、总胆红素、血清白蛋白水平具有显著效果;两组患者的不良反应发生例数相近,且无严重不良反应发生。结论:基于本研究结果,鳖甲煎丸联合替诺福韦能够改善乙型肝炎患者的肝脏纤维化水平和肝功能,且无严重不良反应。由于纳入研究数量和质量的影响,上述结论尚待更多高质量研究予以验证。OBJECTIVE:To probe into the efficacy of Biejiajian pills combined with tenofovir in the treatment of hepatitis B.METHODS:CNKI,CBM,Wanfang Data and VIP were retrieved to collect the randomized controlled trial(RCT)of Biejiajian pills combined with tenofovir versus tenofovir alone in the treatment of hepatitis B.The retrieval time was from establishment of the database to Feb.2024.After two researchers independently screening the literature,extracting the data and evaluating the risk of bias of the included studies,Meta-analysis was performed by using RevMan 5.4 software.RESULTS:Totally 3 RCT were enrolled,including 326 patients.Meta-analysis showed that compared with tenofovir alone,Biejiajian pills combined with tenofovir had no significant effect on reducing all-cause mortality,incidence of liver cancer and negative conversion rate of hepatitis B virus DNA,but had significant effect on improving the liver fibrosis indicators such as serum hyaluronic acid andⅣcollagen type levels,as well as the liver function indicators such as alanine aminotransferase,total bilirubin,and serum albumin levels.The number of adverse drug reactions occurred in both groups was similar,and no severe adverse drug reactions occurred.CONCLUSIONS:Based on the results of the study,Biejiajian pills combined with tenofovir can improve the levels of liver fibrosis and liver function in hepatitis B patients without severe adverse drug reactions.Due to the number and quality of included studies,the above conclusions need to be verified by more high-quality studies.

关 键 词：鳖甲煎丸 替诺福韦 乙型肝炎 META分析 系统评价 

分 类 号：R978.7[医药卫生—药品] R932[医药卫生—药学] R975