Mou Zhiqing, Gong Tao, Wu Yanzuo, Liu Jun, Yu Jianhua, Mao Lichan
Zhejiang University of Traditional Chinese Medicine, Hangzhou, China.
Hangzhou Xixi Hospital, Hangzhou, China.
Front Med (Lausanne). 2024 Jul 2;11:1397900. doi: 10.3389/fmed.2024.1397900. eCollection 2024.
Nonalcoholic fatty liver disease (NAFLD), also known as metabolic associated fatty liver disease (MAFLD), is a common liver condition characterized by excessive fat accumulation in the liver which is not caused by alcohol. The main causes of NAFLD are obesity and insulin resistance. Dachaihu decoction (DCHD), a classic formula in traditional Chinese medicine, has been proved to treat NAFLD by targeting different aspects of pathogenesis and is being progressively used in the treatment of NAFLD. DCHD is commonly applied in a modified form to treat the NAFLD. In light of this, it is imperative to conduct a systematic review and meta-analysis to assess the effectiveness and safety of DCHD in the management of NAFLD. There is a need for a systematic review and meta-analysis to assess the effectiveness and safety of modified DCHD in treating NAFLD.
The objective of this meta-analysis was to systematically assess the clinical effectiveness and safety of DCHD in treating NAFLD.
This meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Including seven databases, both Chinese and English databases were searched for relevant studies. The quality of included studies was carefully assessed using the bias risk assessment tool in the Cochrane Handbook. Eligible articles were the source of extracted data which was meta-analyzed by using Review Manager 5.4 and Stata 17.0.
A total of 10 studies containing 825 patients were included. Compared with conventional treatments, combined treatment could clearly improve the liver function of NAFLD patients, which could reduce the levels of ALT (MD = -7.69 U/L, 95% CI: -11.88 to -3.51, < 0.001), AST (MD = -9.58 U/L, 95% CI: -12.84 to -6.33, < 0.01), and it also had a certain impact on regulating lipid metabolism, which could reduce the levels of TC (MD = -0.85 mmol/L, 95% CI: -1.22 to 0.48, < 0.01), TG (MD = -0.45 mmol/L, 95% CI: -0.64 to 0.21, < 0.01). Adverse event showed that DCHD was relatively safe. Due to the inclusion of less than 10 trials in each group, it was not possible to conduct a thorough analysis of publication bias.
According to the meta-analysis, in the treatment of the NAFLD, it is clear that the combination of DCHD was advantages over conventional treatment alone in improving liver function, regulating lipid metabolism. Additionally, DCHD demonstrates a relatively safe profile. Nevertheless, due to limitations in the quality and quantity of the studies incorporated, the effectiveness and safety of DCHD remain inconclusive. Consequently, further high-quality research is imperative to furnish more substantial evidence supporting the widespread clinical application of DCHD.
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023397353, CRD42023397353.
非酒精性脂肪性肝病（NAFLD），也称为代谢相关脂肪性肝病（MAFLD），是一种常见的肝脏疾病，其特征是肝脏中脂肪过度堆积且并非由酒精引起。NAFLD的主要病因是肥胖和胰岛素抵抗。大柴胡汤（DCHD）是中医经典方剂，已被证明可通过针对发病机制的不同方面来治疗NAFLD，并且正逐渐用于NAFLD的治疗。DCHD通常以改良形式应用于治疗NAFLD。有鉴于此，进行系统评价和荟萃分析以评估DCHD治疗NAFLD的有效性和安全性势在必行。需要进行系统评价和荟萃分析以评估改良DCHD治疗NAFLD的有效性和安全性。
本荟萃分析的目的是系统评估DCHD治疗NAFLD的临床有效性和安全性。
本荟萃分析遵循系统评价和荟萃分析的首选报告项目（PRISMA）指南。搜索了包括七个数据库在内的中英文数据库以查找相关研究。使用Cochrane手册中的偏倚风险评估工具仔细评估纳入研究的质量。符合条件的文章是提取数据的来源，这些数据使用Review Manager 5.4和Stata 17.0进行荟萃分析。
共纳入10项研究，包含825例患者。与传统治疗相比，联合治疗能明显改善NAFLD患者的肝功能，可降低谷丙转氨酶（ALT）水平（MD=-7.69 U/L，95%CI：-11.88至-3.51，P<0.001）、谷草转氨酶（AST）水平（MD=-9.58 U/L，95%CI：-12.84至-6.33，P<0.01），对调节脂质代谢也有一定作用，可降低总胆固醇（TC）水平（MD=-0.85 mmol/L，95%CI：-1.22至-0.48，P<0.01）、甘油三酯（TG）水平（MD=-0.45 mmol/L，95%CI：-0.64至-0.21，P<0.01）。不良事件表明DCHD相对安全。由于每组纳入的试验少于10项，无法对发表偏倚进行全面分析。
根据荟萃分析，在NAFLD的治疗中，显然DCHD联合治疗在改善肝功能、调节脂质代谢方面优于单纯传统治疗。此外，DCHD显示出相对安全的特征。然而，由于纳入研究的质量和数量有限，DCHD的有效性和安全性仍不确定。因此，需要进一步开展高质量研究，以提供更充分的证据支持DCHD的广泛临床应用。
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023397353，CRD42023397353
