[關(guān)鍵詞]
[摘要]
目的 系統(tǒng)評價異甘草酸鎂治療抗結(jié)核藥物所致肝損害的療效和安全性。方法 檢索PubMed、EMbase、Cochrane圖書館、Medline、中國學(xué)術(shù)期刊全文數(shù)據(jù)庫(CNKI)、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(CBM)、萬方數(shù)據(jù)庫和維普數(shù)據(jù)庫,收集國內(nèi)外關(guān)于異甘草酸鎂治療抗結(jié)核藥致肝損害的臨床隨機對照研究(RCTs),評價納入研究的質(zhì)量并提取數(shù)據(jù),使用RevMan 5.3軟件進行Meta-分析。結(jié)果 共納入14篇RCTs,包括1 202名抗結(jié)核藥致肝損害患者。Meta-分析結(jié)果顯示:異甘草酸鎂在治療抗結(jié)核藥致肝損害總有效率[RR=1.38,95% CI (1.24,1.54),P<0.000 01]、降低丙氨酸氨基轉(zhuǎn)移酶(ALT)[MD=-25.98,95% CI (-34.68,-17.29),P<0.000 01]、天冬氨酸氨基轉(zhuǎn)移酶(AST)[MD=-20.21,95% CI (-24.49,-15.93),P<0.000 01]、總膽紅素(TB)[MD=-9.92,95% CI (-16.41,-3.43),P=0.003]、堿性磷酸酶(ALP)[MD=-13.91,95% CI (-26.03,-1.79),P=0.02]方面均優(yōu)于對照組,差異有統(tǒng)計學(xué)意義,同時不良反應(yīng)發(fā)生率低于對照組[RR=0.51,95% CI (0.27,0.96),P=0.04]。結(jié)論 異甘草酸鎂治療抗結(jié)核藥致肝損害臨床療效較好,可顯著降低患者血清ALT、AST、TB和ALP水平,同時具有較高安全性,但本研究納入文獻(xiàn)多為較低質(zhì)量的小樣本研究,尚需更多高質(zhì)量、大樣本的隨機對照試驗進一步支持。
[Key word]
[Abstract]
Objective To evaluate the efficacy and safety of magnesium isoglycyrrhizinate in the treatment of liver injury caused by anti-tuberculosis drugs.Methods PubMed,EMbase,Cochrane Database,Medline,CNKI,the Chinese Biomedical Database (CBM),Wanfang Database and WIP Database were searched to collecte the randomized controlled trials (RCTs) on liver injury patients caused by anti-tuberculosis drugs treated with magnesium isoglycyrrhizin.After screening the literatures,the quality of the included studies and extracted data was evaluated by using the RevMan 5.3 software for meta-analysis.Results A total of 14 RCTs were selected,including 1 202 patients with liver injury caused by anti-tuberculosis drugs.The total effective rate[RR=1.38,95% CI (1.24,1.54),P< 0.000 01],the reduced ALT[MD=-25.98,95% CI (-34.68),-17.29),P< 0.000 01],AST[MD=-20.21,95% CI (-24.49,-15.93),P< 0.000 01],TB[MD=-9.92,95% CI (-16.41,-3.43),P=0.003],ALP[MD=-13.91,95% CI (-26.03,-1.79),P=0.02]were superior to the control group,the difference was statistically significant,and the incidence of adverse reactions was lower than that of the control group[RR=0.51,95% CI (0.27,0.96),P=0.04].Conclusion Magnesium glycyrrhizinate has a good clinical effect in the treatment of liver injury caused by anti-tuberculosis drugs,which can significantly reduce the serum levels of ALT,AST,TB and ALP,and has a higher safety.However,the less quantity of samples,more high-quality and large-sample RCTs are needed to further support.
[中圖分類號]
[基金項目]