中国老年学杂志
中國老年學雜誌
중국노년학잡지
CHINESE JOURNAL OF GERONTOLOGY
2014年
14期
3817-3820
,共4页
龚享文%杨钦河%徐拥建%黄进
龔享文%楊欽河%徐擁建%黃進
공향문%양흠하%서옹건%황진
疏肝健脾法%非酒精性脂肪肝
疏肝健脾法%非酒精性脂肪肝
소간건비법%비주정성지방간
Soothing liver and activating spleen method%Nonalcoholic fatty liver disease
目的:评价疏肝健脾法治疗非酒精性脂肪性肝病的疗效及安全性。方法在 PubMed、EMBASE、CENTRAL 、中国生物医学文献数据库( CBM)和中国期刊全文数据库( CNKI)等数据库中检索从创建以来至2012年9月关于疏肝健脾法治疗非酒精性脂肪肝的随机对照试验文献,由研究人员对文献进行筛选和数据提取,并用 RevMan 5.0进行Meta分析。结果纳入17项研究,1691例非酒精性脂肪性肝病。其中疏肝健脾法901例和西药组790例。 Meta分析显示:疏肝健脾法组临床有效率(OR=4.33,95%CI:3.26~5.74,P<0.001)、肝功能〔ALT(MD=-14.80,95%CI:-21.63~7.96,P<0.00001)、AST(MD=-9.48,95%CI:-13.95~5.01,P<0.001)〕;血脂〔TC(MD=-0.70,95% CI:-1.01~0.39,P<0.001)、TG (MD=-0.72,95%CI:-0.958~0.149),P<0.001〕 B超改变(OR=2.339,5%CI:1.41~3.82,P=0.001)均优于西药组(均P<0.05)。在不良反应上,疏肝健脾方治疗非酒精性脂肪性肝病未出现明显不良反应,但GRADE证据质量所选文献显示为低级别证据,具有很强的偏倚性。结论与单纯西药相比,疏肝健脾法能够更好地治疗非酒精性脂肪性肝病,且具有良好的安全性。有必要可以开展更多高质量的多中心、大样本、前瞻性、随机、双盲临床试验加以验证。
目的:評價疏肝健脾法治療非酒精性脂肪性肝病的療效及安全性。方法在 PubMed、EMBASE、CENTRAL 、中國生物醫學文獻數據庫( CBM)和中國期刊全文數據庫( CNKI)等數據庫中檢索從創建以來至2012年9月關于疏肝健脾法治療非酒精性脂肪肝的隨機對照試驗文獻,由研究人員對文獻進行篩選和數據提取,併用 RevMan 5.0進行Meta分析。結果納入17項研究,1691例非酒精性脂肪性肝病。其中疏肝健脾法901例和西藥組790例。 Meta分析顯示:疏肝健脾法組臨床有效率(OR=4.33,95%CI:3.26~5.74,P<0.001)、肝功能〔ALT(MD=-14.80,95%CI:-21.63~7.96,P<0.00001)、AST(MD=-9.48,95%CI:-13.95~5.01,P<0.001)〕;血脂〔TC(MD=-0.70,95% CI:-1.01~0.39,P<0.001)、TG (MD=-0.72,95%CI:-0.958~0.149),P<0.001〕 B超改變(OR=2.339,5%CI:1.41~3.82,P=0.001)均優于西藥組(均P<0.05)。在不良反應上,疏肝健脾方治療非酒精性脂肪性肝病未齣現明顯不良反應,但GRADE證據質量所選文獻顯示為低級彆證據,具有很彊的偏倚性。結論與單純西藥相比,疏肝健脾法能夠更好地治療非酒精性脂肪性肝病,且具有良好的安全性。有必要可以開展更多高質量的多中心、大樣本、前瞻性、隨機、雙盲臨床試驗加以驗證。
목적:평개소간건비법치료비주정성지방성간병적료효급안전성。방법재 PubMed、EMBASE、CENTRAL 、중국생물의학문헌수거고( CBM)화중국기간전문수거고( CNKI)등수거고중검색종창건이래지2012년9월관우소간건비법치료비주정성지방간적수궤대조시험문헌,유연구인원대문헌진행사선화수거제취,병용 RevMan 5.0진행Meta분석。결과납입17항연구,1691례비주정성지방성간병。기중소간건비법901례화서약조790례。 Meta분석현시:소간건비법조림상유효솔(OR=4.33,95%CI:3.26~5.74,P<0.001)、간공능〔ALT(MD=-14.80,95%CI:-21.63~7.96,P<0.00001)、AST(MD=-9.48,95%CI:-13.95~5.01,P<0.001)〕;혈지〔TC(MD=-0.70,95% CI:-1.01~0.39,P<0.001)、TG (MD=-0.72,95%CI:-0.958~0.149),P<0.001〕 B초개변(OR=2.339,5%CI:1.41~3.82,P=0.001)균우우서약조(균P<0.05)。재불량반응상,소간건비방치료비주정성지방성간병미출현명현불량반응,단GRADE증거질량소선문헌현시위저급별증거,구유흔강적편의성。결론여단순서약상비,소간건비법능구경호지치료비주정성지방성간병,차구유량호적안전성。유필요가이개전경다고질량적다중심、대양본、전첨성、수궤、쌍맹림상시험가이험증。
Objective To evaluate the effectiveness and safety of soothing liver and activating spleen method treating nonalcoholic fatty liver disease.Methods The PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), Chinese Biomedical Abstract Database ( CBM) and China National Knowledge Infrastructure Database ( CNKI) were searched up from establish to September 2012 to find the randomized controlled trials of soothing liver and activating spleen method in the treatment of nonalcoholic fatty liver disease , screening and data extraction by researchers literature ,and Metaa-nalysis with RevMan 5.0.Results 17 clinical trials with 1 691 nonalco-holic fatty liver disease patients were included , 901 patients were in the therapies of soothing liver and activating spleen ,790 patients were in medicine therapy.Meta analysis shows as follow :the clinical effective rate ( OR=4.33 , 95%CI:3.26~5.74 , P<0.000 01 ) ,liver function (ALT MD=-14.80,95%CI :-21.63~-7.96,P<0.000 01),lipids〔TC (MD=-0.70,95%CI:-1.01~0.39,P<0.000 01),TG(MD=-0.72 ,95%CI:-0.958~-0.149 ,P<0.000 01 )〕,B ultrasonic ( OR =2.33 , 95%C I:1.41~3.82 , P=0.0009 ) of Chinese medicine group were better than those of control group.GRADE ratings indicated that all the studies included were low quality ,with high bias.Conclusions Soothing liver and activating spleen method could some extent enhance the effectiveness and the security in the treatment of nonalcoholic fatty liver disease, and make it necessary to carry out more high quality multicenter , large sample, prospective, randomized, double-blind clinical experiments.