中药复方干预抗结核化疗致肝损伤疗效的系统评价
Systematic Evaluation on the Effect of Chinese Medicine Formula on the Intervention of Liver Injury Induced by Anti-Tuberculosis Chemotherapy
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摘要: 目的 系统评价中药复方干预抗结核化疗致肝损伤的有效性。方法 计算机检索中国知网、维普期刊数据库、万方数据和Pub Med数据库，搜集中药复方干预抗结核化疗致肝损伤的随机对照试验（RCT），检索时限均为建库至2019年3月1日。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后，采用RevMan 5.3软件进行Meta分析。结果 共纳入17个RCT，共计1 410位抗结核化疗致肝损伤患者。Meta分析结果提示:与常规保肝治疗比较，中药复方干预抗结核化疗致肝损伤的有效率［RR=1.83，95%CI（1.50，2.23），P<0.01］、血清谷丙转氨酶（ALT）［MD=-50.38，95%CI（-54.17，-46.58），P<0.01］、谷草转氨酶（AST）［MD=-61.65，95%CI（-72.68，-50.61），P<0.01］、总胆红素（TBiL）［MD=-11.02，95%CI（-13.24，-8.79），P<0.01］均优于对照组。结论 中药复方更有利于减轻和控制抗结核化疗过程中肝损伤的发生，对保证结核病人规律服药，控制病情、完成抗结核治疗方案具有重要的意义。Abstract: OBJECTIVE To systematically evaluate the efficacy of Chinese medicine formula in the intervention of liver injury induced by anti-tuberculosis chemotherapy. METHODS CNKI， VIP， Wanfang Data and Pub Med databases were searched to collect randomized controlled trial (RCT) of Chinese medicine formula in intervention of liver injury induced by anti-tuberculosis chemotherapy from inception to the first of March 1， 2019. Two reviewers independently screened literature， extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed by RevMan 5.3 software. RESULTS A total of 17 RCTs involving 1 410 patients with liver injury caused by anti-tuberculosis chemotherapy were included. The results showed that compared to the conventional treatment to protecting liver， intervention with Chinese medicine formula could significantly improve the effective rate RR=1.83，95%CI(1.50，2.23)，P<0.01， and its serum glutamic pyruvic transaminase (ALT) MD=-50.38，95%CI(-54.17，-46.58)，P<0.01， glutamic oxalacetic transaminase (AST)MD=-61.65，95%CI(-72.68，-50.61)，P<0.01， and total bilirubin (TBiL) MD=-11.02，95%CI(-13.24，-8.79)，P<0.01 were all better. CONCLUSION Current evidence shows that Chinese medicine formula is more conducive to reduce and control the occurrence of liver injury in the course of anti-tuberculosis treatment. It is of great significance to ensure that tuberculosis patients take drugs regularly， control their condition and complete the anti-tuberculosis treatment program.
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