基于循证医学评价异甘草酸镁治疗失代偿期肝硬化患者的临床疗效及安全性  

Evaluation of clinical efficacy and safety of magnesium isoglycyrrhizinate in treatment of patients with decompensated liver cirrhosis based on evidence-based medicine

作　　者：富凡春 黄建荣[1] Fu Fanchun;Huang Jianrong(Department of Infectious Disease,The First Affiliated Hospital of Zhejiang University School of Medicine,Zhejiang Hangzhou 310030,China;Department of Infectious Disease,Jiaxing First Hospital,Zhejiang Jiaxing 314000,China)

机构地区：[1]浙江大学医学院附属第一医院感染科,浙江杭州310030 [2]嘉兴市第一医院感染科,浙江嘉兴314000

出　　处：《中国肝脏病杂志(电子版)》2024年第4期17-24,共8页Chinese Journal of Liver Diseases:Electronic Version

基　　金：国家传染病重大专项(2017zx10203201);嘉兴市重点支撑学科-感染性疾病学(2023-ZC-009);嘉兴市病毒相关传染性疾病重点实验室(2021-bdzdsys)。

摘　　要：目的运用Meta分析系统性评价异甘草酸镁治疗失代偿期肝硬化患者的有效性及安全性。方法计算机检索万方数据库、中国生物医学文献数据库、中国知网、维普数据库,PubMed、the Cochrane Library及EMBase数据库,检索时间为建库至2023年5月15日。纳入的研究类型为随机对照试验(randomized controlled trial,RCT),研究对象为失代偿期肝硬化患者,试验组采用异甘草酸镁治疗,对照组不采用异甘草酸镁治疗。由2名研究者独立筛选文献并提取数据进行系统性评价。结果纳入16篇文献,共计1525例患者,其中试验组764例,对照组761例。试验组患者临床有效率显著优于对照组(OR=4.07,95%CI:2.80~5.90,P<0.001),且无不良事件增加(OR=0.66,95%CI:0.35~1.26,P=0.210)。试验组患者丙氨酸氨基转移酶(SMD=-1.63,95%CI:-2.10~-1.16,P<0.001)、天冬氨酸氨基转移酶(SMD=-1.95,95%CI:-2.64~-1.27,P<0.001)和总胆红素(SMD=-1.49,95%CI:-2.15~-0.82,P<0.001)水平显著低于对照组,差异均具有统计学意义。结论异甘草酸镁治疗失代偿期肝硬化患者的效果显著,可提高临床有效率及改善肝功能,安全性良好。Objective To systematically evaluate the efficacy and safety of magnesium isoglycyrrhizinate in the treatment of patients with decompensated liver cirrhosis by Meta-analysis.Methods Wanfang Data,Chinese Biomedical Literature Database,China National Knowledge Infrastructure,VIP Database,PubMed,the Cochrane Library and EMBASE were searched for references from database establishment to May 15th,2023.Randomized controlled trial(RCT)studies were included,and the research subjects were patients with decompensated liver cirrhosis.Patients in experimental group were treated with magnesium glycyrrhizinate,while patients in control group were not treated with magnesium glycyrrhizinate.Two researchers screened the literature and extracted data for systematic evaluation independently.Results A total of 1525 patients were included in 16 studies,including 764 cases in experimental group and 761 cases in control group.The clinical efficacy of patients in experimental group was significantly higher than those in control group(OR=4.07,95%CI:2.80~5.90,P<0.001)and there was no increase in adverse events(OR=0.66,95%CI:0.35~1.26,P=0.210).Alanine aminotransferase(SMD=-1.63,95%CI:-2.10~-1.16,P<0.001),aspartate aminotransferase(SMD=-1.95,95%CI:-2.64~-1.27,P<0.001)and total bilirubin(SMD=-1.49,95%CI:-2.15~-0.82,P<0.001)levels of patients in experimental group were significantly lower than those in control group,the differences were statistically significant.Conclusions Magnesium glycyrrhizinate has a significant therapeutic effect on patients with decompensated liver cirrhosis,which can improve clinical efficacy and liver function,with good safety.

关 键 词：异甘草酸镁 肝硬化 失代偿期 临床有效率 肝功能指标 系统评价 

分 类 号：R28[医药卫生—中药学]