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1.南京中医药大学 附属医院,南京 210029
2.广西中医药大学 第一附属医院,南宁 530023
3.广西中医药大学 附属国际壮医医院,南宁 530200
秦德源,在读硕士,从事中医脾胃病临床研究,E-mail:745666178@qq.com
秦祖杰,教授,从事中医内科临床研究,E-mail:109741754@qq.com
纸质出版日期:2023-12-20,
网络出版日期:2023-10-17,
收稿日期:2023-08-01,
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秦德源,舒发明,毛德文等.中西医结合治疗慢性肝衰竭的Meta分析[J].中国实验方剂学杂志,2023,29(24):163-168.
QIN Deyuan,SHU Faming,MAO Dewen,et al.Meta Analysis of Integrated Traditional Chinese and Western Medicine in Treatment of Chronic Liver Failure[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(24):163-168.
秦德源,舒发明,毛德文等.中西医结合治疗慢性肝衰竭的Meta分析[J].中国实验方剂学杂志,2023,29(24):163-168. DOI: 10.13422/j.cnki.syfjx.20231548.
QIN Deyuan,SHU Faming,MAO Dewen,et al.Meta Analysis of Integrated Traditional Chinese and Western Medicine in Treatment of Chronic Liver Failure[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(24):163-168. DOI: 10.13422/j.cnki.syfjx.20231548.
目的
2
系统评价中西医结合治疗慢性肝衰竭(CLF)的有效性和安全性。
方法
2
检索中英文数据库,包括中国知识基础设施工程(CNKI)、万方数据知识服务平台、中国生物医学文献数据库(CBM)、维普中文科技期刊数据库(VIP)、Cochrane Library、Embase及PubMed,检索日期为建库至2023年1月,筛选纳入符合中西医结合治疗CLF的随机对照试验(RCT)文献,其中对照组采用西医基础治疗,试验组在西医治疗基础上采用中医药治疗。采用Cochrane风险偏倚评估工具评价纳入文献质量,RevMan 5.3软件进行Meta分析。
结果
2
纳入11篇文献,共1 110例患者。Meta分析显示,中西医结合治疗CLF患者在改善临床总有效率[相对危险度(RR)=1.36,95%置信区间(CI)(1.27,1.46),
P
<
0.000 01],降低死亡率[RR=0.35,95% CI(0.23,0.53),
P
<
0.000 01]、丙氨酸氨基转氨酶(ALT)[平均差(MD)=-38.73,95% CI(-54.59,-22.87),
P
<
0.000 01]、天冬氨酸氨基转氨酶(AST)[MD=-58.16,95% CI(-83.45,-32.79),
P
<
0.000 01]、总胆红素(TBil)[MD=-69.21,95% CI(-94.15,-30.53),
P
<
0.000 01]水平,提升血清白蛋白(ALB)[MD=3.24,95% CI(0.82,5.66),
P
=0.009]、凝血酶原活动度(PTA)[MD=5.44,95% CI(3.38,7.50),
P
<
0.000 01]水平及改善中医证候积分[MD=-4.28,95% CI(-8.39,-0.17),
P
=0.04]等方面优于单纯西医治疗。
结论
2
中西医结合治疗慢性肝衰竭具有良好的临床疗效及安全性,但受纳入文献质量与数量的限制,以上结论尚需更大规模的高质量RCT进行验证,值得进一步拓展研究。
Objective
2
To systematically evaluate the efficacy and safety of integrated traditional Chinese and western medicine in the treatment of chronic liver failure(CLF).
Method
2
Several databases was searched from the establishment date of these databases to January, 2023, including China National Knowledge Infrastructure(CNKI), WanFang Data Knowledge Service Platform(WanFang), China Biomedical Literature Database(CBM), VIP Chinese Science and Technology Journal Database(VIP), Cochrane Library, Embase and PubMed. The randomized controlled trial(RCT) conforming to the treatment of CLF with integrated traditional Chinese and western medicine were screened and included, the control group was treated with basic western medicine, and the test group was treated with traditional Chinese medicine on the basis of western medicine. Then, the Cochrane risk bias assessment tool was used to evaluate the quality of the included literature, and Meta analysis was performed by RevMan 5.3 software.
Result
2
Eleven literatures with a total of 1 110 patients were included, and Meta analysis showed that the integrated traditional Chinese and western medicine was better than western medicine alone in the treatment of patients with CLF in improving the overall effective rate[relative risk(RR)=1.36, 95% confidence interval(CI) (1.27, 1.46),
P
<
0.000 01], reducing the mortality[RR=0.35, 95% CI(0.23, 0.53),
P
<
0.000 01)], reducing alanine aminotransferase(ALT) level[mean difference(MD)=-38.73, 95% CI(-54.59, -22.87),
P
<
0.000 01], reducing the aspartate aminotransferase(AST) level[MD=-58.16, 95% CI(-83.45, -32.79),
P
<
0.000 01] and reducing the total bilirubin(TBil) level[MD=-69.21, 95% CI(-94.15, -30.53),
P
<
0.000 01], promoting serum albumin(ALB) level[MD=3.24, 95% CI(0.82, 5.66),
P
=0.009] and prothrombin activity(PTA) level[MD=5.44, 95% CI(3.38, 7.50),
P
<
0.000 01], and improving the traditional Chinese medicine(TCM) symptom score[MD=-4.28, 95% CI(-8.39, -0.17),
P
=0.04].
Conclusion
2
The treatment of CLF with integrated traditional Chinese and western medicine has good clinical efficacy and safety. However, due to the limitations of the quality and quantity of the included literature, the above conclusions still need to be verified by larger scale of high-quality RCT, which is worthy of further expansion of the study.
慢性肝衰竭(CLF)中西医结合治疗系统评价Meta分析有效性安全性循证医学证据
chronic liver failure(CLF)treatment of integrated traditional Chinese and western medicinesystematic reviewMeta analysisefficacysafetyevidence-based medicine
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