A Meta-analysis on magnesium isoglycyrrhizinate in treatment of antituberculosis drug-induced liver injury
-
摘要: 目的 用Meta分析评价异甘草酸镁治疗抗结核药物所致肝损伤的疗效。 方法 检索中国期刊全文数据库（CNKI）、维普网（VIP）、万方数据库、PubMed、EMbase与Cochrane Library，并辅以其他检索方法，纳入异甘草酸镁治疗抗结核药物所致肝损伤患者的随机对照试验（RCTs），检索截至日期为2019年4月。按照纳入和排除的标准由2名研究人员分别独立筛选文献、处理资料与评价所纳入文献的质量。Meta分析结果采用RevMan 5.2软件处理。 结果 本研究全部纳入了10个RCTs，一共有823名患者。Meta分析结果表明：①异甘草酸镁可以有效治疗结核药物所致的肝损伤患者，具有统计学差异；②异甘草酸镁治疗结核药物性肝损伤时可有效改善患者的丙氨酸氨基转移酶（ALT）水平、总胆红素（TBil）水平，与对照组比较，差异有统计学意义。 结论 异甘草酸镁可以有效地治疗抗结核药物所致的肝损伤患者，并促进肝功能快速恢复，但仍需更多高质量的临床研究来进一步证明。Abstract: Objective To evaluate the therapeutic effects of magnesium isoglycyrrhizinate in patients with antituberculosis drug-induced liver injury. Methods The literatures related to randomized controlled trials (RCT) of magnesium isoglycyrrhizinate treatment in patients with antituberculosis drug-induced liver injury were retrieved from CNKI,VIP,WanFang database,PubMed,EMbase and Cochrane Library.The collected literatures were published before April 2019.Based on the inclusive and exclusive criteria,the literatures were screened,and data were extracted by two researchers independently.Meanwhile the quality of the included studies was assessed.Meta-analysis was conducted by RevMan 5.2 software. Results 823 patients with antituberculosis drug-induced liver injury in ten RCT were enrolled.The meta-analysis demonstrated,a) compared with control group,the early-stage administration of magnesium isoglycyrrhizinate can effectively treat liver injury caused by antituberculosis drugs with statistical significance,and b) magnesium isoglycyrrhizinate can significantly reduce the alanine aminotransferase level and improve the total bilirubin level during the treatment. Conclusion Magnesium isoglycyrrhizinate administration is an effective treatment for liver injury caused by antituberculosis drugs although more high-quality researches are needed for further verification.
-
Key words:
- magnesium isoglycyrrhizinate /
- drug-induced liver injury /
- Meta-analysis
-
[1] 中华医学会肝病学分会药物性肝病学组.药物性肝损伤诊治指南[J].临床肝胆病杂志,2015,31(11):1752-1769. [2] LI L,JIANG W,WANG J Y.Clinical analysis of 275 cases of acute drug-induced liver disease[J].Front Med China,2007,1(1):58-61. [3] BJÖRNSSON E S.Epidemiology and risk factors for idiosyncratic drug-induced liver injury[J].Semin Liver Dis,2014,34(2):115-122. [4] WHO.Global Tuberculosis Report2017[R/OL].2017-12[2018-02-18]. [5] ZHANG S M,PAN H Q,PENG X Z,et al.Preventive use of a hepatoprotectant against anti-tuberculosis drug-induced liver injury:A randomized controlled trial[J].J Gastroenterol Hepatol,2016,31(2):409-416. [6] CHANG T E,HUANG Y S,CHANG C H,et al.The susceptibility of anti-tuberculosis drug-induced liver injury and chronic hepatitis C infection:A systematic review and meta-analysis[J].J Chin Med Assoc,2018,81(2):111-118. [7] 李仁仙.异甘草酸镁治疗药物性肝炎50例临床分析[J].亚太传统医药,2011,7(8):75-76. [8] 付贵化,朱红辉,陈红艳.异甘草酸镁治疗结核药物引起药物性肝炎临床观察[J].医药前沿,2012,2:132-133. [9] 高卫红,邵伟杰,雷涛.异甘草酸镁治疗抗结核药物性肝损伤45例[J].中国药业,2013,22(11):122-123. [10] 邓敏,宣华,余晓,等.异甘草酸镁联合谷胱甘肽治疗抗结核药物所致中度以上肝损害疗效观察[J].浙江实用医学,2013,18(3):177-178. [11] 郭新枝,陈裕,程俊伟,等.异甘草酸镁注射液治疗抗结核药物所致急性肝损伤的临床研究[J].微生物与感染,2013,8(3):157-162. [12] 田红华,汪水香.异甘草酸镁治疗抗结核药物引起的药物性肝炎临床疗效观察[J].医药前沿,2014,12:26-27. [13] 陈永芳,程俊伟,陈裕,等.异甘草酸镁注射液治疗抗结核药物所致急性肝损伤的疗效分析[J].北京医学,2014,36(3):223-225. [14] 熊延军,李东方,孙红,等.异甘草酸镁治疗抗结核药物性肝损害的效果分析[J].中国当代医药,2014,21(5):68-69,72. [15] 吴小霞,辛朝雄,李晓云,等.异甘草酸镁治疗抗结核药引起的药物性肝炎的疗效分析[J].现代诊断与治疗,2015,26(6):1272-1274. [16] 白龙.异甘草酸镁治疗结核药物性肝损害的疗效观察[J].临床医药文献杂志,2015,2(27):5724-5726. [17] LIMAMD E F,MELO H R.Hepatotoxicity induced by antituberculosis drugs among patients coinfected with HIV and tuberculosis[J].Cad Saude Publica,2012,28(4):698-708. [18] RANGNEKAR A S,FONTANA R J.An update on drug induced liver injury[J].Minerva Gastroenterol Dietol,2011,57(2):213-229. [19] MANNS M P,WEDEMEYER H,SINGER A,et al.Glycyrrhizin in patients who failed previous interferon alpha-based therapies:biochemical and histological effects after 52 weeks[J].J Viral Hepat,2012,19(8):537-546. -
点击查看大图
计量
- 文章访问数: 3490
- HTML全文浏览量: 445
- PDF下载量: 729
- 被引次数: 0
下载:
