摘要:
Objective To systematically evaluate the efficacy and safety of magnesium isoglycyrrhizinate (MgIG) in the treatment of viral hepatitis based on clinical studies. Methods Searches were conducted in the databases of Cochrane, PubMed,Science Direct,CNKI,CMCI and Wanfang (until Dec.2016 since database setup) to identify randomized controlled tri-als (RCTs) evaluating clinical effects of MgIG vs Compound Glycyrrhizin(CG).Literatures according to inclusion and exclusion criteria were screened.All meta-analysises were conducted with RevMan version 5.3. Results A total of 3 790 patients enrolled in 32 studies were included in the meta-analysis.Firstly,the comparison of curative effect in two groups favors MgIG for the treat-ment of viral hepatitis[OR=2.87,95% CI=(2.29,3.61),P<0.000 01].Secondly,MgIG showed statistically significant benefit in reducing ALT [MD=-17.27,95%CI=(-28.87,-5.66),P=0.004],AST [MD=-14.18,95%CI=(-18.29,-10.08),P<0.000 01] and T-BiL[MD=-4.53,95%CI=(-6.38,-2.68),P<0.000 01].Lastly,comparative trials demonstrated a significant safety advantage of MgIG over CG [OR= 0.29,95%CI=(0.19,0.44),P<0.000 01]. Conclusion MgIG has a significant beneficial effect for the treatment of viral hepatitis by means of both decreasing transaminase and normalizing liver function.Fur-thermore,it is worth for the application in clinical use with less adverse drug reactions.%目的 系统评价异甘草酸镁治疗病毒性肝炎的临床疗效和安全性.方法 计算机检索Cochrane、PubMed、Science Direct、中文期刊全文数据库(CNKI)、中国生物医学期刊引文数据库(CMCI)和万方数据库中相关的随机对照试验(RCT),并追溯纳入文献的参考文献,检索时限为建库至2016年12月.按照纳入和排除标准筛选文献,提取资料并评价质量后,采用RevMan 5.3版软件进行Meta分析.结果 最终筛选纳入RCT文献32篇,共计3790例患者,试验组主要采用异甘草酸镁治疗方案,对照组主要采用复方甘草酸苷治疗方案.在临床总体疗效方面,试验组显著优于对照组,两组差异有统计学意义[OR=2.87,95%CI=(2.29,3.61),P<0.00001].与对照组比较,试验组患者肝功能恢复更好,三项指标均下降更多,ALT[MD=-17.27,95%CI=(-28.87,-5.66),P=0.004],AST[MD=-14.18,95%CI=(-18.29,-10.08),P<0.00001]和T-BiL[MD=-4.53,95%CI=(-6.38,-2.68),P<0.00001].试验组不良反应显著少于对照组[OR= 0.29,95%CI=(0.19,0.44),P<0.00001].结论 异甘草酸镁治疗各类型病毒性肝炎有较好的临床疗效,可促进肝功能恢复,减轻病毒对肝细胞的损伤,且不良反应少,值得临床推广应用.