摘要
目的系统评价拉米夫定(LAM)单用及其与苦参碱联用(LAM+M)治疗慢性乙型肝炎的疗效与安全性。方法计算机检索Cochrane图书馆、PubMed、CNKI、万方及VIP数据库,检索时间均从建库至2012年4月,并追索已获文献的参考文献,纳入LAM单用与LAM+M比较的随机对照试验(RCT)。由2名研究者按照Cochrane Handbook 5.0.2独立进行质量评价及数据提取,而后采用RavMan 5.0软件进行Meta分析。结果共纳入9个RCT,均为C级,合计570例患者。Me-ta分析结果显示:试验组(LAM+M)在主要结局指标(HBV-DNA阴转、HBeAg阴转)和次要结局指标(ALT复常、HBeAg血清转换)上,均优于对照组(LAM),两组差异均有统计学意义。结论现有证据表明,对于慢性乙型肝炎的治疗,LAM+M优于LAM单用,且在治疗3个月时便可观察到明显差异。但受纳入研究的质量影响,上述结论尚需高质量的临床试验进一步证实。
Objective To evaluate the efficacy of Lamivudine monotherapy(LAM) versus Lamivudine-Matrine combination therapy(LAM+M)for chronic hepatitis B. Methods Such databases as The Cochrane Library,PubMed,CNKI,WanFang and VIP Database were searched from the date of their establishment to April 2012,and the references of all included studies were also traced so as to identify randomized controlled trials(RCTs)of LAM versus LAM +M.Quality assessment and data extraction were conducted in accordance with the Cochrane Handbook 5.0.2 by two reviewers independently.Meta-analyses were conducted by using RevMan 5.0 software. Results A total of 9 RCTs involving 570 patients were included.Results of meta-analyses showed that LAM +M group was superior to LAM group with a significant difference in both HBV-DNA negative conversion and HBeAg negative conversion,and the secondary outcome such as ALT normalization,the HBeAg seroconversion rate. Conclusion As the current evidence shows,LAM +M therapy is superior to LAM therapy for chronic hepatitis B.The significant difference can even be observed at the end of the treatment for 3 months.However,the results should be interpreted with caution because of the low quality of the included studies.High-quality,large-scale RCTs are needed to further prove the results.
出处
《时珍国医国药》
CAS
CSCD
北大核心
2013年第4期944-946,共3页
Lishizhen Medicine and Materia Medica Research
基金
上海市卫生局项目(No.2009Y089)
上海市教委重点学科(No.J50303)
上海市卫科技部重大专项(No.2012ZX09303009-001)
作者简介
贺敏（1977-），女（汉族），云南楚雄人，现任上海中医药大学附属曙光医院主治医师，博士学位，主要从事中医临床及基础研究工作
通讯作者：蒋健（1956-），男（汉族），江苏苏州人，现任上海中医药大学附属曙光医院主任医师，博士学位，主要从事中医临床及基础研究工作．
