Song Wei-jiang, Luo Jing, Wu Tong, Yao Shu-kun
Graduate School, Beijing University of Chinese Medicine, Beijing, 100029, China.
Department of Gastroenterology, China-Japan Friendship Hospital, Beijing, 100029, China.
Chin J Integr Med. 2016 Feb;22(2):141-9. doi: 10.1007/s11655-015-2143-0. Epub 2015 May 26.
To evaluate the efficacy and safety of oral oxymatrine preparation for the treatment of chronic hepatitis B (CHB).
Randomized controlled trials (RCTs) on oral oxymatrine preparation in treating patients with CHB were retrieved until October 2013 by searching PubMed, the Cochrane Library, Embase and four Chinese databases, irrespective of language and publication status. Data extraction and data analyses were conducted according to the Cochrane standards. The risk of bias for each included trials and the quality of evidence on pre-specified outcomes were assessed. The RevMan software was used for statistical analyses.
Totally 52 RCTs enrolling 5,227 participants were included, of which 51 RCTs were included in meta-analyses. Oral oxymatrine preparation including oxymatrine capsule and oxymatrine tablet were associated with statistically significant effect on the clearance of hepatitis B virus (HBV) DNA, HBV surface antigen and HBV e antigen, and were beneficial to the normalization of serum alanine aminotransferase and aspartate aminotransferase. Nevertheless, the overall methodological quality and the quality of evidence in the included trials were poor. In addition, safety of oral oxymatrine preparation was not confirmed.
Oral oxymatrine preparation showed some potential benefits for patients with CHB. However, the overall quality of evidence was limited and the safety of oral oxymatrine preparation for CHB patients was still unproven. More high quality evidence from rigorously designed RCTs is warranted to support the clinical use of oral oxymatrine preparation for patients with CHB.
评估口服氧化苦参碱制剂治疗慢性乙型肝炎(CHB)的疗效和安全性。
通过检索PubMed、Cochrane图书馆、Embase和四个中文数据库,检索截至2013年10月的关于口服氧化苦参碱制剂治疗CHB患者的随机对照试验(RCT),不限语言和发表状态。根据Cochrane标准进行数据提取和数据分析。评估每个纳入试验的偏倚风险和预先设定结局的证据质量。使用RevMan软件进行统计分析。
共纳入52项RCT,涉及5227名参与者,其中51项RCT纳入荟萃分析。口服氧化苦参碱制剂,包括氧化苦参碱胶囊和氧化苦参碱片,对乙肝病毒(HBV)DNA、HBV表面抗原和HBV e抗原的清除具有统计学显著效果,且有利于血清丙氨酸氨基转移酶和天冬氨酸氨基转移酶的正常化。然而,纳入试验的总体方法学质量和证据质量较差。此外,口服氧化苦参碱制剂的安全性未得到证实。
口服氧化苦参碱制剂对CHB患者显示出一些潜在益处。然而,证据的总体质量有限,口服氧化苦参碱制剂对CHB患者的安全性仍未得到证实。需要更多来自严格设计的RCT的高质量证据来支持口服氧化苦参碱制剂在CHB患者中的临床应用。