CAJ | 학술논문

目的：系统评价甘草酸类制剂治疗慢性重型乙型肝炎的疗效和安全性。方法利用计算机检索PubMed、Cochrane Li-brary、CBMdisc、CNKI、维普、万方等数据库1990年1月至2014年7月期间公开发表的文献，纳入甘草酸类制剂联合内科综合治疗与单纯内科综合治疗相比较治疗慢性重型乙型肝炎的随机对照试验。对纳入试验独立进行质量评价和资料提取，采用RevMan 5．1软件进行Meta分析，并对其中的异质性、敏感性、偏倚作出判断。结果共纳入7项随机对照研究，包括试验组298例和对照组294例患者。分析结果显示，试验组的病死率及TBil低于对照组，差异具有统计学意义[相对危险度（RR）＝0．56，95％可信区间（CI）：0．42～0．76，P＜0．01；均数差（MD）＝－92．56，95％CI：－122．92～－62．20，P＜0．01]；试验组的凝血酶原活动度（PTA）高于对照组，差异具有统计学意义[MD＝11．14，95％CI：5．40～16．87，P＜0．01]；所有患者未出现严重不良反应。结论甘草酸类制剂可以显著降低慢性重型乙型肝炎患者的病死率，改善TBil和PTA水平。
목적：계통평개감초산류제제치료만성중형을형간염적료효화안전성。방법이용계산궤검색PubMed、Cochrane Li-brary、CBMdisc、CNKI、유보、만방등수거고1990년1월지2014년7월기간공개발표적문헌，납입감초산류제제연합내과종합치료여단순내과종합치료상비교치료만성중형을형간염적수궤대조시험。대납입시험독립진행질량평개화자료제취，채용RevMan 5．1연건진행Meta분석，병대기중적이질성、민감성、편의작출판단。결과공납입7항수궤대조연구，포괄시험조298례화대조조294례환자。분석결과현시，시험조적병사솔급TBil저우대조조，차이구유통계학의의[상대위험도（RR）＝0．56，95％가신구간（CI）：0．42～0．76，P＜0．01；균수차（MD）＝－92．56，95％CI：－122．92～－62．20，P＜0．01]；시험조적응혈매원활동도（PTA）고우대조조，차이구유통계학의의[MD＝11．14，95％CI：5．40～16．87，P＜0．01]；소유환자미출현엄중불량반응。결론감초산류제제가이현저강저만성중형을형간염환자적병사솔，개선TBil화PTA수평。
Objective To systematically evaluate the efficacy and safety of glycyrrhizin in patients with chronic severe hepatitis B.Methods Literature published from January 1990 to July 2014 were searched in databases including PubMed,Cochrane Library,CBMdisc,CNKI, VIP,and Wanfang Data.The randomized controlled trials comparing the efficacy of glycyrrhizin combined with internal comprehensive thera-py versus internal comprehensive therapy alone in patients with chronic severe hepatitis B were included in the analysis.The methodological quality of included trials was independently assessed and the data were extracted.Meta-analysis was carried out with Review Manager Soft-ware 5 .1 ,and the heterogeneity,sensitivity,and bias of the analysis were evaluated.Results Seven randomized controlled trials involving 298 patients in the test group and 294 in the control group were included in the analysis.The results of meta-analysis showed that glycyrrhi-zin combined with internal comprehensive therapy was remarkably more effective than internal comprehensive therapy alone,indicated by sig-nificantly reduced mortality rate [relative risk(RR)=0.56,95%confidenceinterval(CI):0.42~0.76,P<0.01],significantly decreased level of total bilirubin (TBil)[mean difference(MD)=-92.56,95%CI:-122.92~-62.20,P<0.01],and significantly higher pro-thrombin activity (PTA)[mean difference(MD)=11.14,95% CI:5.40~16.87,P<0.01].No severe adverse reactions were found in all patients.Conclusion Glycyrrhizin can significantly reduce the mortality and improve TBil and PTA in patients with chronic severe hepa-titis B.