目的:系统评价不同中成药联合运动、饮食干预治疗非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)的疗效.方法:计算机检索中国知网(CNKI)、维普信息资源系统(VIP)、万方数据知识服务平台(WanFang)、中国生物医学文献数据库(SinoMed)、PubMed、Web of Science、Cochrane Library、Embase数据库,搜集有关水飞蓟宾胶囊、化滞柔肝颗粒、脂必泰胶囊、壳脂胶囊、血脂康胶囊治疗NAFLD的文献,严格按照纳入及排除标准筛选文献,提取纳入文献的资料并评估文献质量,利用R软件、Stata 16.0软件进行贝叶斯网状Meta分析.结果:最终纳入28篇文献,涉及5种中成药、7种干预措施,网状Meta分析结果显示,在总有效率方面,水飞蓟宾胶囊组、化滞柔肝颗粒组、脂必泰胶囊组、壳脂胶囊组均优于基础治疗组(P<0.05),而血脂康胶囊组、单用水飞蓟宾胶囊组与基础治疗的疗效无显著性差异(P>0.05);在血清丙氨酸氨基转移酶指标方面,水飞蓟宾胶囊组、化滞柔肝颗粒组、血脂康胶囊组、壳脂胶囊组均优于基础治疗组(P<0.05),而脂必泰胶囊组、单用水飞蓟宾胶囊组与基础治疗的疗效无显著性差异(P>0.05).累积概率排序结果,在总有效率方面,壳脂胶囊组>化滞柔肝颗粒组>脂必泰胶囊组>水飞蓟宾胶囊组>血脂康胶囊组>单用水飞蓟宾胶囊组>基础治疗组;在血清丙氨酸氨基转移酶方面,化滞柔肝颗粒组>壳脂胶囊组>水飞蓟宾胶囊组>血脂康胶囊组>单用水飞蓟宾胶囊组>脂必泰胶囊组>基础治疗组.结论:使用中成药联合运动、饮食干预治疗NAFLD具有较好的疗效.在总有效率方面,壳脂胶囊联合运动、饮食干预效果最佳的可能性最大;在血清丙氨酸氨基转移酶指标方面,化滞柔肝颗粒联合运动、饮食干预效果最佳的可能性最大.
Efficacy of Oral Chinese Patent Medicine Combined with Exercise and Diet Intervention for Non-Alcoholic Fatty Liver Disease:A Network Meta-analysis
Objective:To systematically evaluate the efficacy of different Chinese patent medicines combined with exercise and dietary intervention in the treatment of NAFLD. Methods:The China National Knowledge Infrastructure (CNKI),VIP Information Resource System (VIP),WanFang Data Knowledge Service Platform (WanFang),SinoMed,PubMed,Web of Science,Cochrane Library,and Embase databases were searched to collect literature on Silybin Capsules,Huazhi Rougan Granules,Zhibitai Capsules,Kezhi Capsules,and Xuezhikang Capsules in the treatment of NAFLD. The literature was screened strictly according to the inclusion and exclusion criteria,the data of the in-cluded literature were extracted,and the quality of the literature was evaluated. Bayesian network meta-analysis was performed using R software and Stata 16.0 software. Results:A total of 28 articles were included,involving 5 Chinese patent medicines and 7 intervention measures. The results of network Meta-analysis showed that in terms of total ef-fective rate,the Silybin Capsule group,Huazhi Rougan Granule group,Zhibitai Capsule group and Kezhi Capsule group were better than the basic treatment group (P<0.05),while there was no significant difference in the efficacy between the Xuezhikang Capsule group and the Silybin Capsule group alone and the basic treatment (P>0.05). In terms of serum alanine aminotransferase index,the Silybin Capsule group,Huazhi Rougan Granule group,Xuezhikang Capsule group and Kezhi Capsule group were better than the basic treatment group (P<0.05),while there was no significant difference in the efficacy between the Zhibitai Capsule group and the Silybin Capsule group alone and the basic treatment (P>0.05). Cumulative probability ranking results showed that in terms of total effective rate,Kezhi Capsule Group>Huazhi Rou-gan Granule Group>Zhibitai Capsule Group>Silybin Capsule Group>Xuezhikang Capsule Group>Silybin Capsule Group>Basic Treatment Group;in terms of serum alanine aminotransferase,Huazhi Rougan Granule Group>Kezhi Capsule Group>Silybin Capsule Group>Xuezhikang Capsule Group>Silybin Capsule Group>Zhibitai Capsule Group>Basic Treatment Group. Conclusion:The use of Chinese patent medicine combined with exercise and dietary intervention has a good therapeutic effect in the treatment of NAFLD. In terms of total effective rate,Kezhi Capsule combined with exercise and dietary intervention has the greatest possibility of having the best effect;in terms of ALT index,Huazhi Rougan Granule combined with exercise and dietary intervention has the greatest possibility of having the best effect.
万方数据
维普
