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目的:评价国内恩替卡韦联合苦参素治疗HBeAg阳性慢性乙型肝炎(chronic hepatitis B,CHB)的疗效与安全性.方法:检索国内2005-2012年公开发表的恩替卡韦联合苦参素与单用恩替卡韦比较治疗HBeAg阳性CHB的随机对照试验,以比值比(odds ratio,OR)为效应量进行异质性检验和统计量合并分析.采用Cochrane协作网提供的RevMan5.2软件进行荟萃分析.结果:经筛选共纳入10项随机对照试验,合计765例患者,其中治疗组382例,对照组383例.荟萃分析结果显示,在治疗结束时,治疗组血清HBV-DNA转阴率高于对照组(81.3%vs66.5%,OR=2.49,95%CI:1.70-3.66),血清HBeAg转阴率高于对照组(52.3%vs26.5%,OR=3.27,95%CI:2.23-4.80),丙氨酸转氨酶复常率高于对照组(88.4%vs68.0%,OR=3.62,95%CI:2.43-5.39),HBeAg血清转换率高于对照组(45.3%vs23.2%,OR=2.98,95%CI:2.00-4.44),差异均有统计学意义(P<0.01).结论:恩替卡韦联合苦参素对HBeAg阳性C H B的抗病毒疗效显著优于恩替卡韦单用,具有较好的安全性和耐受性.
To evaluate the efficacy and safety of entecavir combined with oxymatrine in the treatment of HBeAg-positive chronic hepatitis B (CHB) in China.Methods: To compare the efficacy and safety of entecavir and oxytetrazamide Randomized controlled trials of HBeAg-positive CHB were conducted to assess the odds ratio (OR) of the effect of heterogeneity and statistical analysis.Cultivariate analysis was performed using the RevMan5.2 software provided by the Cochrane Collaboration.Results: A total of 7 randomized controlled trials involving 765 patients, including 382 in the treatment group and 383 in the control group.According to meta-analysis, the serum HBV-DNA negative rate in the treatment group was higher than that in the control group (81.3% vs66.5%, OR = 2.49, 95% CI: 1.70-3.66), serum HBeAg negative rate was higher than that of the control group (52.3% vs26.5%, OR = 3.27,95% CI: 2.23-4.80) The normalization rate of HBeAg seroconversion was higher than that of the control group (88.4% vs68.0%, OR = 3.62, 95% CI: 2.43-5.39, 45.3% vs23.2%, OR = 2.98, 95% CI: 2.00-4.44), the difference was statistically significant (P <0.01) .Conclusion: The effect of entecavir and oxymatrine on HBeAg-positive CHB was significant Entecavir alone, has better safety and tolerability.