苦參素聯合阿德福韋酯或恩替卡韋治療慢性乙型肝炎：系統

StephenW

Kushenin Combined with Adefovir Dipivoxil or Entecavir for Chronic Hepatitis B: A Systematic Review and Meta-Analysis
Qingying Liao  1 , Jianxia Wen  1   2 , Kunxiu Jiang  3 , Yanling Zhao  2 , Xiao Ma  1
Affiliations
Affiliations

    1
    State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.
    2
    Department of Pharmacy, The Fifth Medical Center of PLA General Hospital, Beijing 100039, China.
    3
    School of Pharmacy, Beijing University of Traditional Chinese Medicine, Beijing 102488, China.

    PMID: 33708259 PMCID: PMC7932775 DOI: 10.1155/2021/8856319

Abstract

Kushenin (KS) has become a traditional Chinese medicine preparation that plays an important role in treating chronic hepatitis B (CHB). Many clinical studies have discussed its curative effect and safety in combination with adefovir dipivoxil (ADV) or entecavir (ETV) for treating CHB, but there is still a lack of a systematic analysis. Therefore, this study evaluated the efficacy and safety of KS through a meta-analysis to better guide clinical treatment. Seven databases were searched to identify randomized controlled trials (RCTs) concerning KS combined with ADV or ETV for treating CHB. The primary outcomes included serum viral indices and adverse events, and the secondary outcomes were liver function indices. The risk of bias of the included RCTs was appraised by Cochrane software. STATA 15.1 and Review Manager 5.3 software were used for the meta-analysis. Thirty-two RCTs recruiting 3343 patients with CHB were collected for this meta-analysis. KS combined with ETV or ADV led to an amelioration of the CHB index to various degrees. In short, the meta-analysis indicated that the combination group, compared to the single group, showed great improvement in HBeAg seroconversion, frequency of undetectable HBV-DNA levels, loss of serum HBeAg, and loss of serum HBsAg. The combination treatment also decreased serum HBV-DNA levels when compared to the levels after the single treatment. However, KS combined with ADV or ETV displayed no remarkable difference in the incidence of adverse events or in serum ALT levels. Current evidence showed that, compared with the use of either drug alone, KS combined with ADV or ETV can improve the clinical efficacy of CHB treatment.

Copyright © 2021 Qingying Liao et al.

StephenW

苦參素聯合阿德福韋酯或恩替卡韋治療慢性乙型肝炎：系統評價和薈萃分析
廖慶英1，文劍霞1 2，姜昆秀3，趙艷玲2，小馬1
隸屬關係
隸屬關係

    1個
    成都中醫藥大學藥學院西南中藥資源國家重點實驗室，成都611137
    2個
    解放軍總醫院第五醫學中心藥劑科，北京100039
    3
    北京中醫藥大學藥學院，北京102488。

    PMID：33708259 PMCID：PMC7932775 DOI：10.1155 / 2021/8856319

抽象的

苦參素（KS）已成為一種中藥製劑，在治療慢性乙型肝炎（CHB）中起著重要作用。許多臨床研究已經討論了其與阿德福韋酯（ADV）或恩替卡韋（ETV）聯合治療CHB的療效和安全性，但仍缺乏系統的分析。因此，本研究通過薈萃分析評估了KS的療效和安全性，以更好地指導臨床治療。搜索了七個數據庫，以確定與KS結合ADV或ETV治療CHB的隨機對照試驗（RCT）。主要結果包括血清病毒指數和不良事件，次要結果是肝功能指數。 Cochrane軟件評估了包含的RCT的偏倚風險。薈萃分析使用了STATA 15.1和Review Manager 5.3軟件。這項薈萃分析收集了招募3343名CHB患者的32項RCT。 KS與ETV或ADV的組合可在不同程度上改善CHB指數。簡而言之，薈萃分析表明，與單一組相比，聯合組在HBeAg血清轉化，未檢測到HBV-DNA水平的頻率，血清HBeAg的損失和血清HBsAg的損失方面有很大的改善。與單次治療後的水平相比，聯合治療還降低了血清HBV-DNA水平。但是，KS與ADV或ETV的結合在不良事件發生率或血清ALT水平方面沒有顯示出顯著差異。當前證據表明，與單獨使用任何一種藥物相比，KS與ADV或ETV聯合使用可以改善CHB治療的臨床療效。

版權所有©2021廖慶英等。

StephenW

https://downloads.hindawi.com/journals/ecam/2021/8856319.pdf