Key Laboratory of Environment and Genes Related to Diseases of Education Ministry, Xi'an Jiaotong University School of Medicine, Shaanxi, China.
Antiviral Res. 2011 Feb;89(2):156-64. doi: 10.1016/j.antiviral.2010.12.003. Epub 2010 Dec 15.
BACKGROUND/AIMS: Traditional Chinese herbal therapies are widely used for the treatment of chronic hepatitis C (CHC) in Asia. The aim of this study was to perform a meta-analysis of randomised controlled trials (RCTs) comparing interferon therapies with Chinese herbal therapies and/or interferon plus Chinese herb therapies for the treatment of CHC.
The Cochrane Central Register of Controlled Trials, Medline, Science Citation Index, EMBASE, China National Knowledge Infrastructure, Wanfang Database and China Biomedical Database were searched to identify RCTs that evaluated the virological response to interferon therapies, Chinese herbal therapies and interferon plus Chinese herb therapies in CHC patients. We statistically combined data using a random-effect meta-analysis according to the intention-to-treat principle.
The literature search yielded 770 studies, and 26 RCTs comprising 1905 patients matched the selection criteria. Overall, the sustained virological response (SVR) was significantly higher in patients treated with interferon plus Chinese herbs than in patients treated with interferon alone (49% vs 33%, relative risk, 1.52; 95% confidence interval: 1.23-1.89; p<0.05). Combined therapies of interferon plus Chinese herb therapies were also superior to interferon therapies alone in achieving the end-of-treatment viral response (ETVR), and resulted in fewer relapses, fewer adverse events and more rapid alanine transaminase normalisation. Interferon therapies achieved higher ETVR than Chinese herbal therapies, but they yielded a similar SVR.
The current evidence suggests that combined therapies of interferon plus Chinese herbs yielded a higher SVR, and resulted in fewer relapses and fewer adverse events than interferon therapies.
背景/目的：传统中药疗法在亚洲被广泛用于治疗慢性丙型肝炎（CHC）。本研究旨在对干扰素治疗与中药治疗和/或干扰素加中药治疗 CHC 的随机对照试验（RCT）进行荟萃分析。
检索 Cochrane 中央对照试验注册库、Medline、科学引文索引、EMBASE、中国知网、万方数据库和中国生物医学文献数据库，以确定评估干扰素治疗、中药治疗和干扰素加中药治疗 CHC 患者病毒学应答的 RCT。我们根据意向治疗原则使用随机效应荟萃分析对数据进行统计合并。
文献检索得到 770 项研究，26 项 RCT 包括 1905 例符合入选标准的患者。总体而言，与干扰素单药治疗相比，干扰素加中药治疗的持续病毒学应答（SVR）显著更高（49%比 33%，相对风险 1.52；95%置信区间：1.23-1.89；p<0.05）。干扰素加中药联合治疗在获得治疗结束时的病毒学应答（ETVR）方面也优于干扰素单药治疗，导致更少的复发、更少的不良事件和更快的丙氨酸氨基转移酶正常化。干扰素治疗比中药治疗获得更高的 ETVR，但 SVR 相似。
目前的证据表明，干扰素加中药联合治疗可获得更高的 SVR，并导致更少的复发和更少的不良事件，优于干扰素治疗。
