复方鳖甲软肝片联合恩替卡韦对慢性乙型肝炎血清肝纤维化标志物影响的Meta分析

目的:系统评价复方鳖甲软肝片联合恩替卡韦及单用恩替卡韦对慢性乙型肝炎血清肝纤维化四项指标的影响。方法:计算机检索中国期刊全文数据库(CNKI)、中文科技期刊数据库(VIP)、万方数据资源系统(WANFANG DATA)、中国生物医学文献数据库(CBM)以及英文数据库PubMed、Embase、Web of Science、the Cochrane Library,检索自建库至2015年1月以来复方鳖甲软肝片联合恩替卡韦与单用恩替卡韦治疗慢性乙型肝炎的临床随机对照试验。按纳入和排除标准筛选文献,再进一步提取及分析资料,采用RevMan 5.3软件对多个临床试验结果的总体效应进行Meta分析。结果:共纳入7个临床随机对照试验,共539例患者,观察组272例,对照组267例,均为慢性乙型肝炎治疗的研究。复方鳖甲软肝片联合观察组血清肝纤维化四项指标即透明质酸(HA),层粘连蛋白(LN),Ⅲ型前胶原蛋白(PCⅢ)、Ⅳ型胶原蛋白(IV-C)水平均较单用恩替卡韦组显著降低(P<0.05)。结论:复方鳖甲软肝片联合恩替卡韦能明显降低慢性乙型肝炎血清肝纤维化指标,但由于目前研究质量偏低,尚需要大量、严格、方法学质量高的随机对照试验进一步证实。

Meta-analysis of influences of Fufang Biejia Ruangan Pian combined with entecavir on serum liver fibrosis markers of chronic hepatitis B

OBJECTIVE To evaluate effects of Fufang Biejia Ruangan Pian combined with entecavir and entecavir alone on four serum liver fibrosis markers of chronic hepatitis B. METHODS CNKI, VIP, WANFANG DATA, CBM, PubMed, Embase, Web of Science, and Cochrane Library were searched from inception to January 2015 to collect Fufang Biejia Ruangan Pian combined with entecavir and entecavir alone against chronic hepatitis B: randomized controlled trials. Inclusion and exclusion criteria were used to screen the trials. Data were extracted and analyzed by RevMan 5.3 software to Meta analyze overall effects of multiple clinical test results. RESULTS Seven randomized controlled trials were included, including 539 patients in total, 272 in observation group and 267 in control group. Four serum liver fibrosis indicators, including hyaluronic acid (HA), laminin (LN), type III procollagen (PC III), type IV collagen protein (IV-C) levels, decreased significantly in patients receiving Fufang Biejia Ruangan Pian combined with entecavir compared with those receiving entecavir alone (P<0.05). CONCLUSION Fufang Biejia Ruangan Pian combined with entecavir can significantly decrease serum indexes of liver fibrosis of chronic hepatitis B. However, quality of current research is low, randomized controlled trials with large sample, strict and high quality of methodology are still needed to verify these results.