Comparative effectiveness of five Chinese patent medicines for non-alcoholic fatty liver disease: A systematic review and Bayesian network meta-analysis.

IF 6.7 1区 医学 Q1 CHEMISTRY, MEDICINAL Phytomedicine Pub Date : 2024-10-05 DOI:10.1016/j.phymed.2024.156124
Rui Shi, Keyan Chai, Haojia Wang, Siyu Guo, Yiyan Zhai, Jiaqi Huang, Siyun Yang, Jiaqi Li, Jiying Zhou, Chuanqi Qiao, Xiaoguang Sheng, Xiaomeng Zhang, Jiarui Wu
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Abstract

Background: Non-alcoholic fatty liver disease (NAFLD) is a metabolically stressed liver injury closely related to insulin resistance and genetic susceptibility and has become the leading chronic liver disease in China.

Purpose: To analyze the effectiveness of five Chinese patent medicines used alone or in combination with western medications (WM) for NAFLD using Bayesian network meta-analysis.

Methods: Searches were conducted in Embase, Cochrane Library, PubMed, CNKI, Wanfang Database, VIP, and SinoMed for randomized controlled trials (RCTs) on Danning tablets, Huazhi Rougan granules, Dangfei Liganning capsules, Kezhi capsules, and Qianggan capsules, either alone or in combination with WM for NAFLD, up to January 10, 2024. This study was screened based on pre-designed inclusion and exclusion criteria, and the risk of bias was evaluated using the Cochrane ROB2 tool. The primary outcome was clinical efficacy rate, while secondary outcomes included levels of Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), Triglycerides (TG), and Low-density lipoprotein cholesterol (LDL-C). These data will be analyzed using WinBUGS 1.4.3 and then visualized using Stata 14.0 software.

Results: A total of 77 RCTs involving 7770 patients were included. The results indicated that Huazhi Rougan granules combined with WM (OR = 0.13, 95 % CI 0.05 ∼ 0.26) had a SUCRA probability value of 81.7 %, ranked first in clinical efficacy and significantly improved blood lipids levels including TG, High-density Lipoprotein Cholesterol (HDL-C), and LDL-C, Total cholesterol (TC). For the Chinese patent medicines alone, Danning tablets led with a 75.3 % clinical efficacy rate. Huazhi Rougan granules significantly increased levels of ALT (96.2 %) and AST (MD = -14.48, 95 % CI -23.38 ∼ -5.32). Dangfei Liganning capsules demonstrated significant efficacy in improving TG (73.1 %) and TC (83 %) levels.

Conclusion: In the treatment of NAFLD, the combination of Huazhi Rougan granules and WM demonstrated significant clinical effectiveness and improvement in blood lipid profiles. For different outcome indicators, Danning tablets used alone showed the highest clinical efficacy, while significant improvement in liver function indicators was best achieved with Huazhi Rugan granules used alone.

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五种中成药治疗非酒精性脂肪肝的疗效比较:系统综述和贝叶斯网络荟萃分析。
背景:目的:采用贝叶斯网络荟萃分析法,分析五种中成药单独或与西药联合治疗非酒精性脂肪肝的疗效:方法:在Embase、Cochrane图书馆、PubMed、CNKI、万方数据库、VIP和SinoMed中检索截至2024年1月10日有关丹宁片、华蟾素颗粒、丹妃利肝宁胶囊、克肝胶囊和强肝胶囊单独或与西药联合治疗非酒精性脂肪肝的随机对照试验(RCT)。本研究根据预先设计的纳入和排除标准进行筛选,并使用 Cochrane ROB2 工具评估偏倚风险。主要结果为临床疗效,次要结果包括丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、甘油三酯(TG)和低密度脂蛋白胆固醇(LDL-C)的水平。这些数据将使用 WinBUGS 1.4.3 进行分析,然后使用 Stata 14.0 软件进行可视化:结果:共纳入 77 项 RCT,涉及 7770 名患者。结果显示,华枝红糖颗粒联合WM(OR = 0.13,95 % CI 0.05 ∼ 0.26)的SUCRA概率值为81.7%,临床疗效排名第一,能显著改善血脂水平,包括TG、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)和总胆固醇(TC)。单就中成药而言,大宁片的临床有效率为 75.3%,遥遥领先。华蟾素颗粒能显著提高谷丙转氨酶(96.2%)和谷草转氨酶(MD = -14.48,95 % CI -23.38 ∼ -5.32)的水平。当飞利甘宁胶囊对改善 TG(73.1%)和 TC(83%)水平有明显疗效:结论:在非酒精性脂肪肝的治疗中,华枝茯苓颗粒与 WM 的联合用药显示出显著的临床疗效,并改善了血脂状况。就不同的结果指标而言,单独使用丹宁片的临床疗效最高,而单独使用华枝茹甘颗粒对肝功能指标的显著改善效果最好。
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来源期刊
Phytomedicine
Phytomedicine 医学-药学
CiteScore
10.30
自引率
5.10%
发文量
670
审稿时长
91 days
期刊介绍: Phytomedicine is a therapy-oriented journal that publishes innovative studies on the efficacy, safety, quality, and mechanisms of action of specified plant extracts, phytopharmaceuticals, and their isolated constituents. This includes clinical, pharmacological, pharmacokinetic, and toxicological studies of herbal medicinal products, preparations, and purified compounds with defined and consistent quality, ensuring reproducible pharmacological activity. Founded in 1994, Phytomedicine aims to focus and stimulate research in this field and establish internationally accepted scientific standards for pharmacological studies, proof of clinical efficacy, and safety of phytomedicines.
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