茵陈蒿汤治疗NAFLD随机对照试验的系统评价

摘要

目的 运用Meta分析研究的方法系统、全面的分析评价茵陈蒿汤及其加减治疗非酒精性脂肪性肝病的临床有效率和安全性.方法 运用CNKI、万方数据库、CBM、VIP、Pubmed、EMbase等相关数据库进行检索,联合手工检索医学相关领域期刊杂志,时间限定依据从建库至2017年6月.搜集关于茵陈蒿汤及其加减治疗非酒精性脂肪性肝病的随机对照研究,并由两名专人负责管理进行相关数据分析和质量评估,并采用Review Manager5软件进行Meta分析.结果 最终纳入5项随机对照试验,共685例患者.Meta分析结果显示,未发现双盲实验,在临床有效性方面,祖国传统医药茵陈蒿汤及其加减组优于西医治疗组[RR=6.49,95％CI(3.27,12.91),P＜0.000 01],差异具有统计学意义;茵陈蒿汤及其加减联合西医治疗组组优于单纯西医治疗组[RR=5.40,95％CI(2.27,12.87),P=0.000 01],差异具有统计学意义.结论 现有证据表明,茵陈蒿汤及其加减组或联合西医治疗组优于西医治疗组,但由于研究文献均为小样本和高偏倚风险的原始研究,建议今后开展样本量充足、设计合理、执行严格的临床试验进一步评价.%Objective Using Meta analysis method,to comprehensive analysis and evaluate the clinical effectiveness and safety of artemisia capillaris soup and its addition or subtraction used to treat nonalcoholic fatty liver disease.Methods The related article of CNKI,Wanfang,CBM,VIP,Pubmed,EMbase,and other related magazine,from the date of database creation to August 2016,were searched for randomized controlled study of artemisia capillaris soup and its addition or subtraction used to treat nonalcoholic fatty liver disease.The data was analyzed by Review Manager 5 Meta-analysis software.Results At last,a total of 685 patients and five randomized controlled trial were involved into the analysis.The results showed that,there was no double blind experiment.The clinical effectiveness of artemisia capillaris soup and its addition or subtraction group is superior to that of western medicine treatment group [RR =6.49,95 ％ CI (3.27,3.27),P ＜0.000 01];Artemisia capillaris soup and its addition or subtraction in combination with western medicine treatment group is superior to pure western medicine treatment group [RR =5.40,95 ％ CI (2.27,2.27),P =0.000 01],the difference is statistically significant.Conclusion Artemisia capillaris soup and its addition or subtraction or combined with western medicine therapy group is superior to western medicine treatment group.Because the related paper involved in the analysis has many disadvantages,such as the sample number is little and high risk of bias of the original study.It is suggested that a further clinical trials study of sufficient sample size,reasonable design and strict implementation,should be evaluated.