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目的:系统评价六味五灵片与核苷酸类似物联合治疗慢性乙型病毒性肝炎的疗效。方法:采用Cochrane系统评价方法,在维普资讯中文科技期刊数据库、中国期刊全文数据库、万方数据库、Pub Med、Cochrane等数据库中检索关于六味五灵片与核苷酸类似物联合治疗慢性乙型病毒性肝炎的随机对照试验,对照组患者单一使用恩替卡韦、阿德福韦酯、拉米夫定和替比夫定中的1种,观察组患者在对照组基础上联合应用六味五灵片;治疗检索时间为建库至2016年。由研究人员对文献进行筛选和数据提取,采用Rev Man 5.0软件进行文献荟萃(Meta)分析。结果:共纳入17篇文献,合计1 795例受试对象,其中观察组935例,对照组860例。Meta分析结果显示,与对照组比较,观察组方案可在一定程度上改善患者的临床症状,降低丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、总胆红素水平,提高丙氨酸氨基转移酶复常率,提高乙型肝炎病毒DNA、乙型肝炎病毒E抗原阴转率。结论:与单用核苷酸类似物治疗比较,六味五灵片与核苷酸类似物联合治疗慢性乙型病毒性肝炎在改善临床症状、肝功能和抗病毒方面的疗效更好。
Objective: To systematically evaluate the curative effect of Liuwei Wuling tablet and nucleotide analogues in the treatment of chronic hepatitis B virus. Methods: The Cochrane systematic evaluation method was used to search the database of Chinese Journal of Science and Technology, Chinese Journal Full-text Database, Wanfang database, Pub Med, Cochrane database for the treatment of chronic hepatitis B virus Randomized controlled trials of hepatitis, control group patients with a single use of entecavir, adefovir dipivoxil, lamivudine and telbivudine in a group of patients in the observation group on the basis of the control group combined Liuwei Wuling tablets; treatment Search time for the construction of the library until 2016. Documents were screened and data extracted by researchers, and meta-analyzes were performed using Rev Man 5.0 software. Results: A total of 17 articles were included, totaling 1 795 subjects, 935 in the observation group and 860 in the control group. Meta analysis showed that, compared with the control group, the observation group can improve the clinical symptoms of patients to a certain extent, reduce alanine aminotransferase, aspartate aminotransferase, total bilirubin levels, increase alanine Aminotransferase normalization rate, improve hepatitis B virus DNA, hepatitis B virus E antigen negative conversion rate. Conclusion: Compared with single nucleotide analogues treatment, the combination of Liuwei Wuling tablet and nucleotide analogues in the treatment of chronic hepatitis B is more effective in improving clinical symptoms, liver function and anti-virus.