Meta-analysis of the clinical efficacy of live bifidobacterium bacteria preparation combined with entecavir in the treatment of hepatitis B virus-related cirrhosis
10.3760/cma.j.cn501113-20230309-00097
- VernacularTitle:双歧杆菌活菌制剂联合恩替卡韦治疗乙型肝炎肝硬化临床疗效的meta分析
- Author:
Huan CHEN
1
;
Huixin YUAN
;
Xiuhui LI
Author Information
1. 首都医科大学附属北京佑安医院中西医结合中心，北京 100069
- Keywords:
Liver cirrhosis;
Hepatitis B;
Bifidobacterium;
Entecavir;
Meta analysis
- From:
Chinese Journal of Hepatology
2023;31(3):258-264
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To systematically evaluate the efficacy of live Bifidobacterium preparations combined with entecavir in the treatment of hepatitis B virus-related cirrhosis.Methods:PubMed, Web of Science, CNKI, Wanfang, VIP, and other databases were searched electronically until October 2020. Randomized controlled clinical trials in the treatment of hepatitis B virus-related cirrhosis with live Bifidobacterium preparations combined with entecavir were included for statistical analysis. The relative risk ( RR) was used as the effect size for the count data. Measurement data were expressed as mean difference ( MD) or standardized mean difference ( SMD) to represent the effect size. 95% confidence intervals (95% CI) were calculated for each effect size. The I2 statistic and P-values were used to evaluate the heterogeneity of the included literature. The fixed effect model was used for analysis if I2≤50%, P > 0.1; otherwise, the random effect model was used for meta-analysis. Results:A total of 865 patients from nine studies were included. Among them, 434 cases were in the live Bifidobacterium preparation combined with the entecavir treatment group and 431 cases in the entecavir group. The results showed that compared with the entecavir group, the live bifidobacterium preparation combined with the entecavir treatment group had significantly reduced the four indicators of liver fibrosis: serum hyaluronic acid (HA) ( SMD = -1.87 ng/ml, 95% CI: -2.32 ~ 1.41, P < 0.01), laminin (LN) ( SMD = -1.62 ng/ml, 95% CI: -2.04 ~ 1.19, P < 0.01), type III procollagen peptide (PC-III) ( SMD = -0.98, 95% CI: -1.26 ~ 0.7, P < 0.01), type IIIcollagen (III-C) ( SMD = -1.14 ng/ml, 95% CI: -1.73 ~ 0.55, P < 0.01), portal vein diameter ( SMD = -0.91 mm, 95% CI: -1.27 ~ 0.55, P < 0.01) and spleen thickness ( MD = -3.26mm, 95% CI: -3.95 ~ 2.58, P < 0.01). However, there was no statistically significant difference in the negative conversion rate of hepatitis B virus DNA (HBV DNA) between the two groups of patients. Conclusion:Compared to the entecavir treatment group, the live Bifidobacterium preparation combined with entecavir showed apparent severity improvement and enhanced clinical efficacy in patients with hepatitis B virus-related cirrhosis.
