Shi Ke, Zhang Qun, Hou Jie, Zhang Yi, Bi Yufei, Wang Xianbo
Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
Front Pharmacol. 2022 Jul 12;13:905215. doi: 10.3389/fphar.2022.905215. eCollection 2022.
To assess the efficacy of LiangXue JieDu (LXJD) therapy in combination with Western medicine (WM) for acute-on-chronic liver failure (ACLF). Articles on randomized controlled trials of LXJD therapy for ACLF were obtained from PubMed, Embase, Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure, VIP, Wanfang, and China Biology Medicine databases, with the search range from database inception to March 2022. We evaluated the quality of data from these articles using the Cochrane risk-of-bias tool. Evaluation indicators were total effective rate, mortality rate, complications, liver and coagulation function, and Traditional Chinese medicine (TCM) syndrome score. We then calculated the risk ratio (RR) for dichotomous variables and mean difference (MD) for continuous variables with a 95% confidence interval (CI). The meta-analysis included 18 studies with moderate quality and totaling 1,609 patients. Compared with WM alone, LXJD therapy plus WM improved total effective rate [RR = 1.34, 95% CI: (1.24, 1.45)], while reducing mortality rate [RR = 0.54, 95% CI: (0.42, 0.70)] and complications [RR = 0.43, 95% CI: (0.26, 0.71)]. The combined treatment also improved prothrombin activity [MD = 1.30, 95% CI: (1.02, 1.59)], prothrombin time [MD = -0.90, 95% CI: (-1.40, -0.39)], international normalized ratio [MD = -0.59, 95% CI: (-0.93, -0.25)], alanine aminotransferase [MD = -0.92, 95% CI: (-1.30, -0.55)], aspartate aminotransferase [MD = -0.57, 95% CI: (-0.93, -0.21)], total bilirubin [MD = -1.07, 95% CI: (-1.38, -0.76)], and TCM syndrome score [MD = -1.70; 95% CI: (-2.03, -1.37)]. This study suggests that LXJD therapy plus WM can significantly improves ACLF clinical symptoms and short-term outcomes. However, more high-quality trials are required to confirm the efficacy of LXJD therapy.
评估凉血解毒（LXJD）疗法联合西医（WM）治疗慢性肝衰竭急性发作（ACLF）的疗效。从PubMed、Embase、Cochrane图书馆、Web of Science、中国知网、维普、万方和中国生物医学数据库中获取关于LXJD疗法治疗ACLF的随机对照试验文章，检索范围从数据库建立至2022年3月。我们使用Cochrane偏倚风险工具评估这些文章的数据质量。评估指标包括总有效率、死亡率、并发症、肝脏和凝血功能以及中医证候评分。然后我们计算二分变量的风险比（RR）和连续变量的平均差（MD），并给出95%置信区间（CI）。荟萃分析纳入了18项质量中等的研究，共计1609例患者。与单纯西医治疗相比，LXJD疗法联合西医治疗提高了总有效率[RR = 1.34，95%CI：（1.24，1.45）]，同时降低了死亡率[RR = 0.54，95%CI：（0.42，0.70）]和并发症发生率[RR = 0.43，95%CI：（0.26，0.71）]。联合治疗还改善了凝血酶原活性[MD = 1.30，95%CI：（1.02，1.59）]、凝血酶原时间[MD = -0.90，95%CI：（-1.40，-0.39）]、国际标准化比值[MD = -0.59，95%CI：（-0.93，-0.25）]、谷丙转氨酶[MD = -0.92，95%CI：（-1.30，-0.55）]、谷草转氨酶[MD = -0.57，95%CI：（-0.93，-0.21）]、总胆红素[MD = -1.07，95%CI：（-1.38，-0.76）]以及中医证候评分[MD = -1.70；95%CI：（-2.03，-1.37）]。本研究表明，LXJD疗法联合西医治疗可显著改善ACLF的临床症状和短期预后。然而，需要更多高质量试验来证实LXJD疗法的疗效。
