还原型谷胱甘肽治疗药物性肝病的系统评价.pdfVIP

还原型谷胱甘肽治疗药物性肝病的系统评价 ＊ # 何 梅 ，占 美，柳汝明，唐 尧（四川大学华西医院药剂科，成都市 610041） + 中图分类号 R975.5；R575 文献标识码 A 文章编号 1001-0408（2010）32-3049-04 摘 要 目的：系统评价还原型谷胱甘肽（GSH ）治疗药物性肝病的疗效。方法：计算机检索Cochrane 图书馆和PubMed 、Medline 、 Embase 、CBM、VIP 、CNKI 数据库；手工检索相关中文杂志。按纳入与排除标准选择试验、评价质量、提取资料。并用RevMan 5.0 软件对数据进行Meta 分析。结果：共纳入13篇随机对照试验，Meta 分析结果显示，试验组与对照组中总有效率、丙氨酸氨基转移 酶、总胆红素等指标组间差异有统计学意义（P ＜0.05）。结论：与基础治疗以及其它保肝药如甘草酸二铵、葡糖醛内酯相比，GSH 可明显提高药物性肝病临床疗效、改善肝功能各指标。但由于纳入研究较少，研究质量不高，上述结论还需多中心、大样本、随机 双盲对照临床试验加以证实。 关键词 还原型谷胱甘肽；药物性肝病；中毒性肝病；系统评价 Systematic Review on Reduced Glutathione in the Treatment of Drug-induced Liver Disease HE Mei ，ZHAN Mei ，LIU Ru-ming ，TANG Yao （Dept. of Pharmacy ，West China Hospital of Sichuan Universi- ty ，Chengdu 610041，China ） ABSTRACT OBJECTIVE ：To evaluate the efficacy of reduced glutathione in the treatment of drug-induced liver disease. METH- ODS ：Literatures were retrieved from PubMed ，Medline ，EMBASE ，Cochrane Library ，CBM ，VIP ，CNKI databases by computer and from relevant Chinese medical journals by hand. Trial selection ，quality evaluation and information extraction were performed according to including and excluding criteria. Meta-analysis was conducted using RevMan 5.0 software. RESULTS ：The meta-anal- ysis of 13 included RCTs showed that total effective rate ，ALT and total bilirubin in trial group were significantly different from control group （P ＜0.05）. CONCLUSIONS ：Compared with routine therapy ，diammonium glycyrrhizinate ，glucurolactone ，reduced glutathione can significantly improve clinical efficacy and liver fuction. While the number and quality of included study are not satis- factory ，the study result should be confirmed by multi-centre and large-scale randomized double-blind control trials. KEY WORDS Reduced glutathione ；Drug-induced liver disease ；Toxipathic liver disease ；Systematic review 肝脏是药物代谢的主要脏器，也是药物损伤的主要靶器