摘要
目的评价苦参素联合阿德福韦酯治疗慢性乙型肝炎患者(CHB)的安全性和有效性。方法计算机检索Cochrane图书馆(2009年第1期)、PubMed(1975～2009.3)、中国生物医学文献数据库(1978～2009.3)和中文科技期刊全文数据库(1989～2009),同时手工检索其他相关文献,查找苦参素联合阿德福韦酯治疗CHB的随机对照试验(RCT)。按照纳入与排除标准选择文献、评价质量,提取数据,而后采用RevMan5.0.0软件进行Meta分析。结果共纳入10个RCT,合计855例CHB患者,其中试验组436例,对照组419例。Meta分析结果显示,苦参素联合阿德福韦酯组患者治疗12月后的血清ALT复常率、血清HBV-DNA转阴率、血清HBeAg转阴率以及HBeAg/抗HBe血清转换率均优于单用阿德福韦酯组,且差异有统计学意义,其RR及其95%CI分别为1.28(1.17,1.40)、1.27(1.13,1.42)、1.80(1.32,2.44)、2.11(1.47,3.03)。结论苦参素联合阿德福韦酯治疗CHB,能明显提高乙肝患者的HBsAg/抗HBs血清转换率,而达到较好的治疗效果。
Objective To review the effcacy and safety of Kushenin combined with Adefovir Dipivoxil for Chronic Hepatitis B （CHB）. Method Randomized controlled trails of Kushenin combined with Adefovir Dipivoxil for CHB were gathered from PubMed, CBMdisc （1978 to 2009）, and CSJD （1989 to 2009）, while other relative researches were searched manually; every research was evaluated, and then analyzed with RevMan 5.0.0 software. Result Ten randomized controlled trials were included; among total 855 patients, 436 were in trial group and the other 419 were in control group. As the Meta-analysis showed, the therapeutic effect of kushenin combined with Adefovir Dipivoxil was better than that of Adefovir Dipivoxil in aspects of improving the negative rate of serum ALT （RR=1.28, 95%CI 1.17 to 1.40）, the nega-tive rate of serum HBV-DNA （RR=1.27, 95%CI 1.13 to 1.42）, the negative rate of serum HBeAg （RR=1.80, 95%CI 1.32 to 2.44）, and the conversion rate of HBeAg and anti-HBe （RR2.06, 95%CI 1.43 to 2.95）. Conclusion Kushenin combined with Adefovir Dipivoxil in treating CHB can improve the conversion rate of HBeAg and anti-HBe and further take better therapeutic effect.
出处
《中国循证医学杂志》
CSCD
2010年第10期1182-1187,共6页
Chinese Journal of Evidence-based Medicine
