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[异甘草酸镁联合核苷类似物治疗慢性乙型肝炎患者的Meta分析]

[Meta-analysis of magnesium isoglycyrrhizinate combined with nucleoside analogues in patients with chronic hepatitis B].

作者信息

Yan Ze-Hui, Wang Yu-Ming, Tang Bo, Yu Yue-Cheng, He Deng-Ming, Wang Xiao-Hong, Mao Qing

机构信息

Institute for Infectious Diseases of PLA, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.

出版信息

Zhonghua Gan Zang Bing Za Zhi. 2014 Feb;22(2):108-12. doi: 10.3760/cma.j.issn.1007-3418.2014.02.008.

Abstract

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. mono-therapy) 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% CI: -18.24 to -7.71, P less than 0.01) and for AST of -9.49 (95% CI: -14.53 to -4.45, P = 0.0002) and RRs for HBeAg of 1.79 (95% CI: 1.17 to 2.76, P = 0.008) and for HBV DNA of 1.35 (95% CI: 1.05 to 1.74, P = 0.02). The therapeutic efficacy of MGL+NA combination therapy was better than that of NA mono-therapy (P less than 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.

摘要

目的

采用荟萃分析方法评估异甘草酸镁联合核苷类似物(MGL + NA)治疗慢性乙型肝炎患者的疗效和安全性。

方法

检索中国生物医学文献数据库(CBMDisc)和中国科学期刊数据库CNKI,查找1995年至2013年间发表的关于MGL + NA治疗慢性乙型肝炎患者的随机对照试验(RCT)。收集与治疗类型(联合治疗与单药治疗)和结局(疗效和安全性指标,包括乙肝病毒(HBV)DNA水平、乙肝e抗原(HBeAg)、谷丙转氨酶(ALT)和谷草转氨酶(AST))相关的数据。计算加权平均差(WMD),并采用Peto法确定相对风险(RR),两者均给出95%置信区间(CI)。

结果

对纳入的6项MGL + NA的RCT进行荟萃分析,共704例慢性乙型肝炎患者,结果显示ALT的WMD为-12.98(95%CI:-18.24至-7.71,P<0.01),AST的WMD为-9.49(95%CI:-14.53至-4.45,P = 0.0002),HBeAg的RR为1.79(95%CI:1.17至2.76,P = 0.008),HBV DNA的RR为1.35(95%CI:1.05至1.74,P = 0.02)。MGL + NA联合治疗的疗效优于NA单药治疗(P<0.01)。

结论

对于慢性乙型肝炎患者,MGL联合治疗可能增强NA治疗的抗病毒疗效,并有助于改善治疗期间的肝功能。

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