CAJ | 학술논문

目的根据现有临床研究资料及结果评价异甘草酸镁联合核苷类似物治疗慢性乙型肝炎的疗效及安全性.方法从1995至2013年中国生物医学光盘数据库和中国期刊网数据库,检索异甘草酸镁联合核苷类似物治疗慢性乙型肝炎的研究文献,并对相关研究进行荟萃分析.计量资料选用加权均数差值(WMD),计数资料采用Peto方法进行统计学分析.结果共6项随机对照试验(RCT) 704例患者入选.Meta分析结果显示:ALT∶WMD=-12.98,其95％可信区间为-18.24～-7.71,P＜0.01;AST:WMD =-9.49,其95％可信区间为-14.53 ～-4.45,P=0.0002 ; HBeAg:RR=1.79,其95％可信区间为1.17 ～ 2.76,P=0.008;HBV DNA∶RR=1.35,其95％可信区间为1.05 ～ 1.74,P=0.02;异甘草酸镁联合核苷类似物治疗慢性乙型肝炎的疗效显著优于单用核苷类似物,两组比较,差异有统计学意义(P＜0.01).结论异甘草酸镁与核苷类似物联合治疗可促进肝功能恢复和提高抗病毒疗效.
목적 근거현유림상연구자료급결과평개이감초산미연합핵감유사물치료만성을형간염적료효급안전성.방법 종1995지2013년중국생물의학광반수거고화중국기간망수거고,검색이감초산미연합핵감유사물치료만성을형간염적연구문헌,병대상관연구진행회췌분석.계량자료선용가권균수차치(WMD),계수자료채용Peto방법진행통계학분석.결과 공6항수궤대조시험(RCT) 704례환자입선.Meta분석결과현시:ALT∶WMD=-12.98,기95％가신구간위-18.24～-7.71,P＜0.01;AST:WMD =-9.49,기95％가신구간위-14.53 ～-4.45,P=0.0002 ; HBeAg:RR=1.79,기95％가신구간위1.17 ～ 2.76,P=0.008;HBV DNA∶RR=1.35,기95％가신구간위1.05 ～ 1.74,P=0.02;이감초산미연합핵감유사물치료만성을형간염적료효현저우우단용핵감유사물,량조비교,차이유통계학의의(P＜0.01).결론 이감초산미여핵감유사물연합치료가촉진간공능회복화제고항병독료효.
Objective To evaluate the efficacy and safety of the magnesium isoglycyrrhizinate plus nucleoside analogues (MGL + NA) combination therapy in patients with chronic hepatitis B using a meta-analysis approach.Methods The Chinese Biochemical literature on Disc (CBMDisc) and the Chinese Scientific Journal database,CNKI,were searched for randomized controlled trials (RCTs) of MGL+NA in patients with chronic hepatitis B published between 1995 and 2013.Data related to treatment type (combination therapy vs.monotherapy) and outcome (markers of efficacy and safety,including levels of hepatitis B virus (HBV) DNA,hepatitis B e antigen (HBeAg),alanine aminotransferase (ALT) and aspartate aminotransferase (AST)).Weighted mean differences (WMD) were calculated and the Peto method was used to determine the relative risk (RR),both with 95％ confidence intervals (CIs).Results Meta-analysis of the six included RCTs of MGL + NA,representing a 704 patients with chronic hepatitis B,showed WMDs for ALT of-12.98 (95％ CL:-18.24 ～-7.71,P ＜ 0.01) and for AST of-9.49 (95％ CI:-14.53 ～-4.45,P =0.0002) and RRs for HBeAg of 1.79 (95％ CI:1.17 ～ 2.76,P =0.008) and for HBV DNA of 1.35 (95％ CI:1.05 ～ 1.74,P =0.02).The therapeutic efficacy of MGL+NA combination therapy was better than that ofNA mono-therapy (P ＜ 0.01).Conclusion For patients with chronic hepatitis B,MGL combination therapy may enhance the antiviral efficacy of NA treatment and help to improve liver function during treatment.