水飞蓟素治疗非酒精性脂肪肝效果和安全性的Meta分析

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摘要目的评价水飞蓟素治疗非酒精性脂肪性肝病的效果与安全性。方法搜索水飞蓟素治疗NAFLD的RCT文献,检索2016年7月前以下数据库收录的文献：PubMed、Embase、the Cochrane Library、CBM、万方、维普和CNKI,按纳入排除标准对纳入研究进行资料提取和方法学质量评价后,采用RevMan 5.3进行分析。结果最终纳入14篇文章（1337例）。水飞蓟素组和对照组ALT、AST、TG、BMI的差异有统计学意义,分别为ALT：WMD=-14.16,95%CI（-22.02,-6.30）,P=0.0004;AST：WMD=-9.17,95%CI（-14.20,-4.15）,P=0.0003;TG：WMD=-0.23,95%CI（-0.42,-0.03）,P=0.02;BMI：WMD=-0.84,95%CI（-1.34,-0.34）,P=0.001。对疾病谱分别为NAFLD和NASH的ALT、AST水平进行亚组分析,发现仅NAFLD组差异有统计学意义。少数患者发生轻微不良反应。结论目前有限证据提示水飞蓟素可改善NAFLD患者ALT、AST、TG、BMI水平,且不良反应少。

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	黄倩
	吴银莲
	康娜玲

关键词 ：水飞蓟素, 非酒精性脂肪肝, Meta分析

Abstract：Objective To evaluate the therapeutic effect and safety of silymarin in the treatment of nonalcoholic fatty liver disease (NAFLD).Methods RCT articles about treating NAFLD with silymarin were published in databases including PubMed,Embase,the Cochrane Library,CBM,Wanfang Data,VIP,and CNKI before July 2016 were searched.The included articles were used to extract data and assess the methodology quality according the inclusion/exclusion criteria.Then all the datas were analyzed with RevMan 5.3.Results A total of 14 artilces including 1337 cases were fitted for Meta-analysis.After treatment,ALT,AST,TG and BMI were significant different between silymarin-treated group and control group (ALT:WMD=-14.16,95%CI (-22.02,-6.30),P=0.0004;AST:WMD=-9.17,95%CI (-14.20,-4.15),P=0.0003;TG:WMD=-0.23,95%CI (-0.42,-0.03),P=0.02;BMI:WMD=-0.84,95%CI (-1.34,-0.34),P=0.001.The subgroup analysis showed ALT and AST were significantly different between silymarin-treated group and control group in NAFLD cases,but not in NASH cases.The adverse reactions were low and mild.Conclusion Silymarin can improve ALT,AST,TG and BMI with low adverse reactions according limited evidence for now.

Key words： Silymarin Nonalcoholic fatty liver disease Meta-analysis

收稿日期: 2017-06-20

PACS:

R575.5

作者简介: 黄倩（1986-）,女,硕士研究生,住院医师,研究方向：脂肪肝

引用本文:

黄倩, 吴银莲, 康娜玲. 水飞蓟素治疗非酒精性脂肪肝效果和安全性的Meta分析[J]. 中国当代医药, 2017, 24(25): 8-13.
HUANG Qian, WU Yin-lian, KANG Na-ling. Meta-analysis of the therapeutic effect and safety of silymarin in the treatment of nonalcoholic fatty liver disease. 中国当代医药, 2017, 24(25): 8-13.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2017/V24/I25/8

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