拉米夫定联合中药干预慢性乙型肝炎发生HBeAg血清学转换时间的系统评价

目的 评价拉米夫定(LMD)与中药联合干预对慢性乙型肝炎(CHB)的抗病毒疗效,以及中药"治未病"的预防作用在LMD耐药株产生之前对血清学应答的影响.方法 计算机检索中国期刊全文数据库、万方中国学位论文全文数据库、维普期刊全文数据库、中国生物医学文献数据库、MEDLINE、EMBASE、BIOSIS以及Cochrane对照试验注册资料库鉴定文献,加上手工检索中文发表及未发表的文献.纳入单独使用LMD及其联合中药治疗CHB的随机对照试验(RCT).研究数据的统计学分析采用Cochrane协作网提供的RevMan 4.2软件.结果 最终纳入1项RCT、6项半随机对照试验(OCT)共578例CHB患者.对此7篇文献的Meta分析显示,在6、9、12个月时联合干预组HBeAg转换率高于对照组,差异有统计学意义.结论 现有研究结果 显示,干预组与对照组比较:6个月以上的中药联合干预可能会在LMD开始产生耐药的同时发生血清学应答,提高HBeAg血清学转换率.由于系统评价纳入的RCT、CCT和患者数量有限,且存在选择性偏倚和发表偏倚,期待有高质量的随机双盲对照实验提供有效证据.

Evaluation on HBeAg conversion time when treating chronic hepatitis B patients with combination of lamivudine and traditional Chinese medicine

Objective To evaluate the effect of the combined use of traditional Chinese medicine and lamivudine(LMD) in treating chronic hepatitis B patients, and to follow the serological response for six months or longer. Methods CNKI, Wanfang data, VIP data, CBMdisk, MEDLINE,EMBASE,BIOSIS and Cochrane Central Register of Controlled Trials database and literature were searched, to include randomized controlled trails (RCT) that used LMD alone or combined with traditional Chinese medicine. RevMan 4.2 was used for data analysis. Results The Meta analysis of 7 trails demonstrated that the HBeAg conversion rate in treatment group was higher than those from the control group, and the differences were statistically significant at 6, 9, 12 months. Conclusion Data demonstrated that early intervention of traditional Chinese medicine might increase the HBeAg conversion rate but conclusion needs to be more specific to the types of trials.