甘草有效组分治疗非酒精性脂肪肝的系统评价

目的评价甘草有效组分治疗非酒精性脂肪肝(NAFLD)的有效性与安全性。方法计算机检索10个中英文数据库(时间均自建库~2013年12月),纳入甘草有效组分治疗NAFLD随机对照试验(RCT)文献,对其方法学质量及终点指标行合成分析。结果共纳入28个RCT合计2260例NAFLD患者,其方法学质量均属于高偏倚风险。所有RCT试验组采用甘草有效组分制剂或结合西药或中成药治疗,对照组采用西药或中成药治疗,均未报告主要终点,仅报告次要终点,有16个RCT报告不良反应结局指标。Meta分析结果显示试验组治疗后天门冬氨酸氨基转移酶、丙氨酸氨基转移酶、γ-谷氨酰基转移酶、甘油三酯、总胆固醇改善效果及总有效率显著优于对照组。结论甘草有效组分治疗NAFLD有效且安全,但由于所纳入的RCT方法学质量均较低,需要开展更为严格的RCT以提供充分证据支持临床应用甘草有效组分治疗NAFLD。

Systematic Review on Nonalcoholic Fatty Liver Disease Treated with the Effective Components of Liquorice

Objective To evaluate the effectiveness and safety of the effective components of liquo-rice in the treatment of nonalcoholic fatty liver disease（NAFLD）. Methods Ten databases of Chinese and English versions were retrieved（from the date of database building till December 2013）. The literatures were included on the randomized controlled trial（RCT）of NAFLD treated with the effective components of liquo-rice. The synthetic analysis was done on the methodological quality and final endpoints. Results Totally, 2260 cases of NAFLD and 28 RCT were collected. The methodological quality was high risk of bias. In all RCT groups,the cases were treated with the preparation of the effective components of liquorice,or combined with western medicine or Chinese medicine. In the control group,western medicine or Chinese medicine was adopted. The secondary endpoints were reported,rather than the primary one. The outcome indicators were re-ported in 16 RCT. Meta analysis results showed that the improvements in AST,ALT,GGT,TG and TC,as well as the total effective rate in the trial group were significant better than those in the control group. Conclusion methodological quality of RCT included,it is required to develop rigorous RCT so as to provide the adequate evidences to support the clinical application of the effective components of liquorice in the treatment of NAFLD.