CAJ | 학술논문

目的：系统评价腺苷蛋氨酸治疗胆汁淤积性肝病的效果。方法：计算机检索中国生物医学文献数据库（CBM）、维普中文科技期刊数据库（VIP）、中国期刊全文数据库（CNKI）、中文生物医学期刊文献数据库（CMCC）及万方数据库，对纳入的随机及半随机对照试验进行质量评价，并用RevMan 5.0软件进行Meta分析。结果：共纳入5项研究，合计患者428例。腺苷蛋氨酸组(治疗组)降低总胆红素（TBil）、直接胆红素（DBil）、谷草转氨酶（AST）和谷丙转氨酶（ALT）疗效均优于对照组，升高白蛋白（ALB）疗效与对照组相当；亚组分析显示，无论2周或4周疗程，治疗组降TBil、DBi疗效均优于对照组；在4周疗程中治疗组降ALT、AST疗效优于对照组，而在2周疗程中两组降ALT、AST疗效相当。现有资料未提示明显不良反应。结论：腺苷蛋氨酸治疗胆汁淤积性肝病有一定的退黄降酶效果，适当延长治疗时间可能提高疗效。其疗效和安全性尚待更多高质量研究予以进一步证实。
목적：계통평개선감단안산치료담즙어적성간병적효과。방법：계산궤검색중국생물의학문헌수거고（CBM）、유보중문과기기간수거고（VIP）、중국기간전문수거고（CNKI）、중문생물의학기간문헌수거고（CMCC）급만방수거고，대납입적수궤급반수궤대조시험진행질량평개，병용RevMan 5.0연건진행Meta분석。결과：공납입5항연구，합계환자428례。선감단안산조(치료조)강저총담홍소（TBil）、직접담홍소（DBil）、곡초전안매（AST）화곡병전안매（ALT）료효균우우대조조，승고백단백（ALB）료효여대조조상당；아조분석현시，무론2주혹4주료정，치료조강TBil、DBi료효균우우대조조；재4주료정중치료조강ALT、AST료효우우대조조，이재2주료정중량조강ALT、AST료효상당。현유자료미제시명현불량반응。결론：선감단안산치료담즙어적성간병유일정적퇴황강매효과，괄당연장치료시간가능제고료효。기료효화안전성상대경다고질량연구여이진일보증실。
Objective:To evaluate the efficacy of S-Adenosyl-L-Methionine(SAMe)in patients with cholestatic liver diseases. METHODS:Retrieved from Cochrane library,PubMed,CB M,VIP,CNKI,CMCC and Wanfang database,included randomized control ed trails(RCT)and qusi-randomized control ed trails(qRCT)were evaluated and analyzed using RevMan 5.0 software. RESULTS:5 studies were included,involving 428 patients.It showed that SAMe group (treatment group) provided better efficacy than control group in decreasing TBIL、DBil、ALT and AST in patients with cholestatic liver diseases,but similar efficacy to control group in increasing ALB.Subgroup analysis showed that in either 2 or 4 weeks treatment,treatment group was superior to control group for reducing TBIL and DBil;In 4 weeks treatment,treatment group was superior to control group for reducing ALT and AST, while ALT and AST decreased equal y in both groups in 2 weeks treatment.No obvious adverse drug reaction was reported.CONCLUSIONS:SAMe may abate jaundice and lower enzyme in patients with cholestatic liver diseases. It may enhance the therapeutic effect after proper protracted treatment.While more high-qualified studies are required to validate the therapeutic efficacy and safety.