A meta-analysis of diammonium glycyrrhizinate enteric-coated capsules versus diammonium glycyrrihizinate in patients with chronic viral hepatitis / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To systematically evaluate the efficacy and safety of diammonium glycyrrhizinate enteric-coated capsules versus diammonium glycyrrihizinate in patients with chronic viral hepatitis.</p><p><b>METHODS</b>The Chinese Biomedical Literature Database (CBM on CD-ROM) and the China Academic Journals Full-Text Database (Chinese National Knowledge Infrastructure, CNKI) were searched for randomized controlled trials (RCTs) that compared the efficacy and safety of diammonium glycyrrhizinate entetic-coated capsules versus diammonium glycyrrihizinate in treatment (less than 2 months) of chronic viral hepatitis published between 2005 and 2012. A meta-analysis was performed on the selected RCTs to determine the effects on alanine aminotransferase (ALT) normalization, serum levels of ALT, aspartate aminotransferase (AST), total bilirubin (TBil) and albumin, as well as rates of adverse reactions.</p><p><b>RESULTS</b>Nine RCTs, involving 687 patients, were included in the meta-analysis. Compared to the patients treated with diammonium glycyrrihizinate, the patient treated with diammonium glycyrrhizinate enteric-coated capsules had a significantly better recovery rate of ALT (relative risk (RR) =4.15, 95% confidence interval (CI):1.55 to 11.15, P less than 0.01) and significantly more robust decreases in ALT (weighted mean difference (WMD) = -32.75, 95% CI:-46.67 to-18.83, P less than 0.01) and AST (WMD = -12.70, 95% CI:-21.13 to-4.27, P less than 0.01). In contrast, the patients treated with diammonium glycyrrihizinate showed more robust improvements in the TBil level (WMD = -0.74, 95% CI:3.98 to 2.49, P =0.653) and albumin (WMD =1.03, 95% CI:-1.03 to 3.09, P =0.326), but the differences did not reach the threshold for statistical significance (P less than 0.05). Only four adverse reactions were reported, all of which were related to the lipid complex nature of the diammonium glycyrrhizin enteric-coated capsules and were mild, including dry mouth, dizziness and mild gastrointestinal discomfort and reactions.</p><p><b>CONCLUSION</b>Diammonium glycyrrhizinate enteric-coated capsules elicited superior anti-inflammatory and liver protection effects than diammonium glycyrrihizinate, and produced only mild side effects that are tolerable to the patients.</p>

Correlation between chronic hepatitis B and serum triglyceride and cholesterol levels / 中华传染病杂志

Objective To investigate the relationship between various stages of chronic hepatitis B virus (HBV) infection and lipid metabolism and its influencing factors.Methods Seventy-two cases of chronic hepatitis B (CHB),40 cases of liver cirrhosis and 17 cases of hepatocellular carcinoma (HCC) were enrolled.One-way ANOVA analyses were used to compare age,gender,liver function,lipid metabolism,and HBV DNA levels of each group.Pearson correlation analysis was used to study the correlation between HBV DNA and lipid metabolism.Binary Logistic regression analyses were performed to explore the risk factors of cirrhosis and HCC in patients with CHB.Results Differences of age,alanine aminotransferase (ALT),albumin (Alb),triglyceride (TG),and cholesterol(CHO) among the three groups (CHB group,cirrhosis group and HCC group) were statistically significant (all P＜0.05).TG levels in cirrhosis and HCC groups were (-0.061± 0.234)lg mmol/L and (-0.061±0.253) lg mmol/L,respectively,which were both significantly lower than that of the CHB group (0.116±0.182) lg mmol/L (F=11.466,P=0.000).CHO level in cirrhosis group was (0.460±0.333) lg mmol/L,which was lower than that in CHB group (0.586±0.101) lg mmol/L (F=4.892,P=0.009).The HBV DNA levels inversely correlated with TG and CHO levels in CHB group (r=-0.266,P=0.024; r=-0.309,P=0.008,respectively).The HBV DNA levels of cirrhosis and HCC patients positively correlated with ALT levels (r=0.355,P =0.007).Old age (OR=1.096,95％CI:1.025-1.172),low Alb (OR=0.000,95％CI:0.000-0.000),and low levels of ALT (OR=0.128,95％CI:0.026-0.641) were risk factors for development of cirrhosis and HCC in CHB patients (all P＜0.05).Conclusions With the progression of liver injuries,TG and CHO levels are reduced.Further studies of correlation between risk factors for the development of cirrhosis and HCC and lipid metabolism in CHB patients are needed.