湖北中医药大学学报
湖北中醫藥大學學報
호북중의약대학학보
JOURNAL OF HUBEI UNIVERSITY OF CHINESE MEDICINE
2015年
4期
111-114,115
,共5页
王彬%马利%龙远雄%李瀚旻
王彬%馬利%龍遠雄%李瀚旻
왕빈%마리%룡원웅%리한민
慢性乙型肝炎%HBeAg阴性%中药%阿德福韦酯%系统评价
慢性乙型肝炎%HBeAg陰性%中藥%阿德福韋酯%繫統評價
만성을형간염%HBeAg음성%중약%아덕복위지%계통평개
chronic Hepatitis B%HBeAg-negative%traditional Chinese medicine%Adefovir dipivoxil%system evaluation
目的：系统评价中药联合阿德福韦酯（ ADV）治疗HBeAg阴性慢性乙型肝炎的有效性和安全性。方法计算机检索中国知网、重庆维普、万方、PubMed和Cochrane 5大数据库，全面搜集中药联合阿德福韦酯治疗HBeAg阴性慢性乙型肝炎的相关文献。由两名研究者共同制定纳入、排除标准，严格筛选纳入文献，并逐个进行方法学质量评级和资料提取，采用Review Manager 5．2软件进行Meta分析。结果最终纳入8个随机对照试验文献（ RCT），共计HBeAg阴性慢性乙型肝炎患者584例，其中试验组303例，对照组281例。文献的方法学质量评价均为C级。 Meta分析结果显示：中药联合ADV组的HBV DNA转阴率优于单用ADV组（RR＝1．24，95％CI（1．06，1．45））；中药联合ADV组治疗后AST水平低于单用ADV组（WMD＝－19．22，95％CI（－21．09，－17．36））；中药联合ADV组治疗后TBIL水平低于单用ADV组（WMD＝－3．65，95％CI（－5．17，－2．14））；两组差异均具有统计学意义。结论中药联合ADV治疗HBeAg阴性慢性乙型肝炎在抗病毒和改善肝功能方面可能优于单用ADV，尚未发生严重不良反应，其循证医学证据还需后续研究纳入大样本、高质量临床研究进一步证实。
目的：繫統評價中藥聯閤阿德福韋酯（ ADV）治療HBeAg陰性慢性乙型肝炎的有效性和安全性。方法計算機檢索中國知網、重慶維普、萬方、PubMed和Cochrane 5大數據庫，全麵搜集中藥聯閤阿德福韋酯治療HBeAg陰性慢性乙型肝炎的相關文獻。由兩名研究者共同製定納入、排除標準，嚴格篩選納入文獻，併逐箇進行方法學質量評級和資料提取，採用Review Manager 5．2軟件進行Meta分析。結果最終納入8箇隨機對照試驗文獻（ RCT），共計HBeAg陰性慢性乙型肝炎患者584例，其中試驗組303例，對照組281例。文獻的方法學質量評價均為C級。 Meta分析結果顯示：中藥聯閤ADV組的HBV DNA轉陰率優于單用ADV組（RR＝1．24，95％CI（1．06，1．45））；中藥聯閤ADV組治療後AST水平低于單用ADV組（WMD＝－19．22，95％CI（－21．09，－17．36））；中藥聯閤ADV組治療後TBIL水平低于單用ADV組（WMD＝－3．65，95％CI（－5．17，－2．14））；兩組差異均具有統計學意義。結論中藥聯閤ADV治療HBeAg陰性慢性乙型肝炎在抗病毒和改善肝功能方麵可能優于單用ADV，尚未髮生嚴重不良反應，其循證醫學證據還需後續研究納入大樣本、高質量臨床研究進一步證實。
목적：계통평개중약연합아덕복위지（ ADV）치료HBeAg음성만성을형간염적유효성화안전성。방법계산궤검색중국지망、중경유보、만방、PubMed화Cochrane 5대수거고，전면수집중약연합아덕복위지치료HBeAg음성만성을형간염적상관문헌。유량명연구자공동제정납입、배제표준，엄격사선납입문헌，병축개진행방법학질량평급화자료제취，채용Review Manager 5．2연건진행Meta분석。결과최종납입8개수궤대조시험문헌（ RCT），공계HBeAg음성만성을형간염환자584례，기중시험조303례，대조조281례。문헌적방법학질량평개균위C급。 Meta분석결과현시：중약연합ADV조적HBV DNA전음솔우우단용ADV조（RR＝1．24，95％CI（1．06，1．45））；중약연합ADV조치료후AST수평저우단용ADV조（WMD＝－19．22，95％CI（－21．09，－17．36））；중약연합ADV조치료후TBIL수평저우단용ADV조（WMD＝－3．65，95％CI（－5．17，－2．14））；량조차이균구유통계학의의。결론중약연합ADV치료HBeAg음성만성을형간염재항병독화개선간공능방면가능우우단용ADV，상미발생엄중불량반응，기순증의학증거환수후속연구납입대양본、고질량림상연구진일보증실。
Abstracts:Objective To evaluate the efficacy and safety of Traditional Chinese Medicine combined with adefovir( ADV) in treatment of HBeAg-negative chronic hepatitis B.Methods Five databases such as CNKI, VIP, Wanfang, PubMed and the Cochrane were searched to collect relevant literature on adefovir dipivoxil combined with Chinese herbal medicine in treatment of HBeAg-negative chronic hepatitis B.Two researchers jointly developed inclusion and exclusion criteria and screened included literatures which were methodological quality ra-ted and information extracted one by one rigorously.To make META analysis using Review Manager 5.2 software .Results A total of eight RCTs were included eventually,involving 584 cases of HBeAg-negative chronic hepatitis B patients, of which 303 cases of test group and <br> 281cases of control group.Methodological quality of all were C-level .Meta-analysis showed that :HBV DNA negative rate of TCM joint ADV group was higher than alone ADV group (RR =1.24,95%CI (1.06,1.45));AST levels of ADV combined TCM group below alone ADV group (WMD =-19.22,95%CI (-21.09, -17.36));TBIL level of ADV combined TCM group was lower than with ADV group (WMD =-3.65,95%CI (-5.17, -2.14));Differences between the experimental and control groups above analysis were statistically significant .Conclusion TCM combined with ADV in treatment of HBeAg-negative chronic hepatitis B in antiviral and improving liver function might be superior to single-use ADV, and serious adverse reactions had not yet occurred.Its evidence based medicine needs a fol-low study included a large samples,high quality clinical study to further confirmed.
