【摘要】 目的根据现有临床研究,系统评价岩黄连注射液治疗病毒性肝炎的有效性。方法检索1998年至2007年的医学数据库及会议论文集,获得以病毒性肝炎为研究对象,观察岩黄连治疗效果的对照临床试验。总计15项临床试验1332例患者纳入荟萃分析。临床评价指标包括治疗有效率、丙氨酸转移酶降低百分比(ALTR)和总胆红素降低百分比(TBR)。应用RevMan4.2分析软件进行统计,选择随机效应模型计算总的治疗效应。结果岩黄连与阳性保肝药物相比,治疗有效率的相对危险度(RR)为1.32(1.10,1.58),ALTR的加权均数差(WMD)为11.11(2.68,19.54),TBR的WMD为23.62(14.91,32.33)。基础保肝药物加岩黄连与单用基础护肝药物比较,治疗有效率的RR为1.39(1.18,1.64),ALTR的WMD为6.30(0.58,12.05),TBR的WMD为9.09(-0.37,18.55)。岩黄连联合用药与阳性对照比较,治疗有效率的RR为1.33(1.09,1.63),ALTR的WMD为8.59(0.22,16.96),TBR的WMD为21.27(10.35,32.20)。结论岩黄连注射液具有保肝、退黄作用,可以治疗病毒性肝炎。但由于纳入研究可能存在选择性偏倚、实施偏倚以及发表偏倚,影响结果的可靠性。更多还原

【Abstract】 Objective To evaluate the efficacy of Corydalis saxicola Injection(CSI) in the treatment of viral hepatitis. Methods Published clinical trials that compared the efficacy of CSI and other kind of treatment for viral hepatitis were chosen through a computerized search of medical database and a manual search of meeting abstracts from 1998 to 2007. Fifteen controlled clinical trials involving 1332 viral hepatitis patients were systematically reviewed by meta-analysis. The main outcome measures were relative risk(RR) of efficacy rate,weighted mean difference(WMD) of percentage of alanine aminotransferase reduction(ALTR% ),and WMD of percentage of total bilirubin reduction(TBR% ). The pooled estimates were carried out in RevMan version 4.2 software according to a random effect model. Results When comparing CSI with positive liver-protective drugs,RR of efficacy rate was 1.32(1.10,1.58),WMD of ALTR% was 11.11(2.68,19.54),and WMD of TBR% was 23.62(14.91,32.33). When comparing CSI combined with standard treatment with standard treatment,RR of efficacy rate was 1.39(1.18,1.64),WMD of ALTR% was 6.30(0.58,12.05),and WMD of TBR% was 9.09(-0.37,18.55). When comparing CSI combination therapy with positive control drugs,RR of efficacy rate was 1.33(1.09,1.63),WMD of ALTR% was 8.59(0.22,16.96),and WMD of TBR% was 21.27(10.35,32.20). Conclusions CSI is effective in reducing ALT and TB,and it can be used in the treatment of viral hepatitis. However,due to the potential risk of selection bias,performance bias and publication bias,the evidence is not strong enough to judge that CSI is as effective as the existing postive drugs. It is suggested that large-scale randomized trials should be performed.更多还原