摘要
目的了解中西医联合治疗HBeAg阴性慢性乙型肝炎的现状和发展趋势,科学评价中医药在HBeAg阴性慢性乙型肝炎防治中的作用和优势,为后续临床治疗和研究提供有价值的参考依据。方法制定文献纳入标准和排除标准,全面检索中国期刊全文数据库、中文科技期刊数据库、中国生物医学文献数据库、中国优秀硕博论文数据库、中国学术会议论文集数据库等5大中文文献数据库关于中西医联合治疗HBeAg阴性慢性乙型肝炎的临床观察文献,对纳入文献进行方法学质量评级,采用专用软件Rev Man 4.2对入选文献进行Meta分析。结果最终纳入系统评价有11篇RCT文献,共计929例患者,其中中西医联合治疗组549例,西药对照组380例,全部文献的方法学质量评级均为"c级"。分别有7篇及6篇文献报告了肝功能指标ALT、AST治疗前后的变化,由于异质性过高,均放弃meta分析。分别有6篇及9篇文献报告了肝功能指标TBIL变化及DNA阴转率,采用随机效应模型进行meta分析,两组差异均有统计学意义(P<0.05)。结论中西医联合治疗HBeAg阴性慢性乙型肝炎在改善肝功能及抗病毒疗效总体优于单用西药治疗,可为系统评价中医药疗效提供可参考的循证医学证据。
Objective To understand the present situation of the Chinese-Western combination treatment for HBeAg negative chronic hepatitis B, evaluate the function and superiority of TCM in HBeAg negative chronic hepatitis B , and provide reference for subsequent clinical treatment and research. Methods The inclusion and exclusion criteria of literatures were established, and then the original literatures about Chinese-Western combination treatment for HBeAg negative chronic hepatitis B were retrieved from Chinese Journal full database （ CJFD ）, Chinese Academic Journal, CBM, China outstanding thesis database and China academic conference proceedings database. The included documents were assessed according to their quality and analyzed by Rev Man software 4. 2 version Results 11 RCT trials were brought into systematic re- view, including 929 patients, of which 549 patients were in the Chinese-Western treatment group, there were another 380 patients in Western treatment group, and all the literature methodology quality rating were ＂c level＂. Furthermore, the liv- er function index ALT, AST were reported respectively by 7 articles and 6 articles, all of which failed to do meta analysis because of high heterogeneity. The meta analysis result of 6 articles about TBIL showed that the differences between two groups were statistically significant through the random effect model, Another 6 articles about negative conversion ratio of DNA showed the same results. Conclusions Combined Chinese-Western medicine treatment of HBeAg B negative chronic hepatitis, in terms of improving liver function and antiviral effect, were better than the general western medicine treat- ment, this provides reference evidence for EBM systematic evaluation of traditional Chinese medicine efficacy.
出处
《公共卫生与预防医学》
2013年第1期22-26,共5页
Journal of Public Health and Preventive Medicine
