活血化瘀法治疗非酒精性脂肪性肝病的疗效评价：系统评价和随机对照试验的荟萃分析。

Evaluation of HuoXueHuaYu therapy for nonalcoholic fatty liver disease: a systematic review and meta-analysis of randomized controlled trial.

机构信息

School of Traditional Chinese Medicine, Jinan University, Guangzhou, China.

Division of Histology and Embryology, Key Laboratory for Regenerative Medicine of the Ministry of Education, Medical College, Jinan University, Guangzhou, China.

出版信息

BMC Complement Altern Med. 2019 Jul 19;19(1):178. doi: 10.1186/s12906-019-2596-3.

BACKGROUND

To evaluate the effectiveness and safety of HuoXueHuaYu (HXHY) therapy in treating nonalcoholic fatty liver disease (NAFLD) through a systematic review and meta-analysis.

METHODS

We performed comprehensive searches on Embase, Pubmed, Cochrane Library, CNKI, VIP and Wanfang databases up to June 2017 for randomized controlled trials using HXHY in the treatment of NAFLD compared with conventional treatment.

RESULTS

This meta-analysis included 13 studies involving 1429 patients which 775 patients belonged to HXHY group and 654 patients belonged to conventional treatment group. The results of meta-analysis showed that HXHY can significantly improve B ultrasonic level (OR = 2.33; 95% CI:1.60, 3.40; P < 0.00001) of NAFLD compared with conventional treatment. As to lipids, HXHY was tested to be better on reduction of total cholesterol (TC) (MD = -0.38, 95% CI: - 0.48, - 0.29; P < 0.00001) and triglyceride (TG) (MD = -0.31; 95% CI: - 0.37, - 0.24; P < 0.00001) than conventional treatment. HXHY also had a greater beneficial effect on liver function in reducing alanine transaminase (ALT) (MD = -1.69; 95% CI: - 2.24, - 1.14; P < 0.00001) and aspartate transaminase (AST) (MD = -22.53; 95% CI: - 33.16, - 11.90; P < 0.00001) compared with conventional treatment. HXHY can also significantly improve the effective rate (OR = 3.55; 95% CI:2.65, 4.76; P < 0.00001) compared with conventional treatment. No serious adverse reactions were reported.

CONCLUSIONS

HXHY seems to be an effective and safe therapy for NAFLD. It is suggested that further study of HXHY in the treatment of NAFLD requires trials with rigorous design, multicenter, large-scale and high-quality worldwide.

背景

通过系统评价和荟萃分析评估活血化瘀疗法治疗非酒精性脂肪性肝病（NAFLD）的有效性和安全性。

方法

我们对 Embase、Pubmed、Cochrane 图书馆、CNKI、VIP 和万方数据库进行了全面检索，截至 2017 年 6 月，检索了活血化瘀疗法与常规治疗相比治疗 NAFLD 的随机对照试验。

结果

本荟萃分析共纳入 13 项研究，共 1429 例患者，其中 775 例患者为活血化瘀组，654 例患者为常规治疗组。荟萃分析结果显示，与常规治疗相比，活血化瘀疗法能显著改善 NAFLD 的超声水平（OR=2.33；95%CI：1.60，3.40；P<0.00001）。对于血脂，活血化瘀疗法在降低总胆固醇（TC）（MD=-0.38，95%CI：-0.48，-0.29；P<0.00001）和三酰甘油（TG）（MD=-0.31；95%CI：-0.37，-0.24；P<0.00001）方面优于常规治疗。活血化瘀疗法在降低丙氨酸转氨酶（ALT）（MD=-1.69；95%CI：-2.24，-1.14；P<0.00001）和天门冬氨酸转氨酶（AST）（MD=-22.53；95%CI：-33.16，-11.90；P<0.00001）方面也有更大的有益作用与常规治疗相比。与常规治疗相比，活血化瘀疗法还能显著提高有效率（OR=3.55；95%CI：2.65，4.76；P<0.00001）。未报告严重不良反应。