[Meta-analysis of the clinical efficacy of live bifidobacterium bacteria preparation combined with entecavir in the treatment of hepatitis B virus-related cirrhosis].

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 I (2)≤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.