苦参素联合阿德福韦酯治疗慢性乙型肝炎的系统评价.doc

苦参素联合阿德福韦酯治疗慢性乙型肝炎的系统评价 苏娜1,2，吴斌2，徐珽2，唐尧2* （1.四川大学华西临床医学院，四川 成都610041; 2.四川大学华西医院药剂科,四川 成都610041） 摘要 目的：评价苦参素联合阿德福韦酯治疗慢性乙型肝炎患者（CHB）的安全性和有效性。 方法：计算机检索PubMed、中国生物医学文献数据库（1978—2009）、中文科技期刊全文数据库（1989—2009）纳入苦参素联合阿德福韦酯治疗CHB的随机对照试验（RCT）文献，手工检索其他的相关文献，对纳入研究进行方法学质量评价，并采用RevMan5.0.0软件对其进行Meta分析。 结果：共纳入10个RCT，苦参素联合阿德福韦酯治疗CHB患者的血清ALT复常率，血清HBV-DNA转阴率，血清HBeAg转阴率，HBeAg/抗HBe血清转换率，联合组均优于单用组，且差异有统计学意义，其RR和95%CI分别为：[RR1.28，95%CI(1.17, 1.40)]、[RR1.27，95%CI(1.13, 1.42)]、[RR1.80，95%CI(1.32, 2.44)]、[RR2.06，95%CI(1.43, 2.95)]。结论：苦参素联合阿德福韦酯治疗CHB，能明显提高乙肝患者的HBsAg/抗HBs血清转换率，而达到较好的治疗效果。 关键词：苦参素；慢性乙型肝炎；系统评价 Efficacy and Safety of Kushenin combined with Adefovir Dipivoxil in the Treatment of Chronic Hepatitis B: A Systematic Review Su Na1,2,Wu Bin2 ,Xu Ting2, Tang Yao2* 1. West China Medical School, Sichuan University, Chengdu 610041, China 2. Department of Pharmacy, West China Hospital, Sichuan University, Chengdu 610041, China Abstract Objective：Review the effect and safety of Kushenin combined with Adefovir Dipivoxil for Chronic Hepatitis B (CHB) 。Method：Randomized controlled trails of Kushenin combined with Adefovir Dipivoxil for CHB were gathered from PubMed, CBMdisc(1978~2009), CNKI(1979~2009), while other relative researches were hand-searched; Every research was evaluated, then analysised by software of RevMan5.0.0. Result:Ten randomized controlled trials were included. The therapeutic effect of kushenin combined with Adefovir Dipivoxil was better than that of Adefovir Dipivoxil alone, Kushenin combined with Adefovir Dipivoxil improved the effective ratio of the negative rate of serum ALT , the negative rate of serum HCV-DNA, the negative rate of serum HBeAg，the HBeAg and anti-HBe transformation,the RR and 95%CI of the results were [RR1.28，95%CI(1.17, 1.40)]、[, 1.42)]、[RR1.80，95%CI(1.32, 2.44)]、[, 2.95)]. Conclusion Kushenin combined with Adefovir Dipivoxil for CHB can improve the effective ratio of the HBeAg and anti-HBe transformation and achieve the better therapeutic effec