痰热清注射液对病毒性肝炎患者肝功能影响的Meta分析

摘要

目的 评价痰热清注射液对病毒性肝炎患者肝功能指标的影响,为临床用药提供循证依据.方法 计算机检索中国期刊全文数据库(CNKI)、万方医学网、PubMed和Ovid中英文数据库,检索时限自2003年1月至2014年8月.按纳入与排除标准筛选文献,提取数据和评价纳入研究的方法质量后,采用RevMan 5.3.5软件进行Meta分析.结果 共纳入11个随机对照试验,共864例患者.均分为观察组与对照组,观察组在对照组治疗基础上加用了痰热清.Meta分析结果显示:观察组肝功能指标总胆红素[均数差(MD):15.50,95％置信区间(CI):13.85 ～ 17.15,P＜0.000 01]、天冬氨酸转氨酶(MD:20.42,95％ CI:3.99 ～ 36.84,P=0.01)、丙氨酸转氨酶改善(MD:23.57,95％CI:0.80 ～46.35,P=0.04)均较对照组更明显,差异均有统计学意义(P＜0.05).结论 痰热清注射液治疗病毒性肝炎可明显改善肝功能指标总胆红素、天冬氨酸转氨酶和丙氨酸转氨酶.但本研究纳入文献的质量较低,需更多高质量临床试验支持验证.%Objective To evaluate the influence and safety of Tanreqing injection on liver function in virus hepatitis using Meta-analysis.Methods China National Knowledge Infrastructure (CNKI), Wanfang database, PubMed and Ovid database were searched to retrieve the relevant studies from 2003 to August of 2014.According to the including and excluding criteria, the literatures were included, then the data were extracted and the study quality was assessed.Meta-analysis was performed by using RevMan 5.3.5 software.Results Eleven randomized controlled trials including 864 patients were included;the patients were all divided into observation group and control group.Meta-analysis showed that compared with those in control group, the liver function indices such as total bilirubin, aspartate aminotransferase and alanine aminotransferase were better improved in observation group compared with those in control group [mean difference (MD) : 15.50, 95％ confidence interval (CI) :13.85-17.15, P＜0.000 01;MD: 20.42, 95％CI: 3.99-36.84, P=0.01;MD: 23.57, 95％CI: 0.80-46.35,P =0.04].Conclusions Tanreqing injection can effectively improve the liver function indices such as total bilirubin, aspartate aminotransferase and alanine aminotransferase;while more clinical trials with higher quality are need to support the conclusion because the included literatures in this study show low quality.