Meta-analysis On Indirect Comparison Of Fuzheng Huayu Capsules And Biejia Ruangan Tablets In Treatment Of Chronic Hepatitis B With Liver Fibrosis

Objective: To investigate the relative efficacy of Fuzheng Huayu Capsules and Biejia Ruangan Tablets in the treatment of chronic hepatitis B fibrosis.Methods: Searching domestic and foreign databases by computer and manual search and the search period is from the time the database was established to 1October 2021.Firstly,screening and data extraction from the literature were carried out according to inclusion and exclusion criteria and the quality of the literature was evaluated using the modified Jadad scale.And then conventional Meta-analysis was performed using Rev Man 5.2 software and complemented by Stata 14 software.Finally,indirect Meta-analysis was performed using ITC software.Results: Traditional Meta-analysis:(1)A total of 18 randomized controlled trial studies were included,with Fuzheng Huayu Capsules combined with entecavir in the trial group and entecavir alone in the control group.Meta-analysis results show that: In terms of serum liver fibrosis indexes,the trial group significantly reduced the levels of hyaluronic acid,laminin,type III procollagen and type IV collagen compared with the control group.In terms of liver function indicators,the trial group significantly reduced glutamate transaminase and total bilirubin compared with the control group.In terms of imaging parameters,the trial group was able to significantly reduce portal vein internal diameter,spleen thickness,and liver stiffness values compared to the control group.In addition,the trial group was able to significantly increase the rate of HBV-DNA conversion compared to the control group.The differences in all of the above indicators were statistically significant.In terms of liver histopathology,there was no significant difference in reducing liver fibrosis stage and liver inflammation grade in the trial group compared to the control group.In addition,there was no significant difference in the incidence of adverse reactions between the trial group and the control group,and the differences in the above indicators were not statistically significant.(2)A total of 17 randomized controlled trial studies were included,with Biejia Ruangan Tablets combined with entecavir in the trial group and entecavir alone in the control group.Meta-analysis results show that: In terms of serum liver fibrosis indexes,the trial group significantly reduced the levels of hyaluronic acid,laminin,type III procollagen and type IV collagen compared with the control group.In terms of liver function indicators,the trial group significantly reduced glutamate transaminase and total bilirubin compared with the control group.In terms of imaging parameters,the trial group was able to significantly reduce portal vein internal diameter,spleen thickness,and liver stiffness values compared to the control group.In addition,the trial group was able to significantly increase the rate of HBV-DNA conversion and significantly increase the index of APRI compared to the control group.In terms of the incidence of adverse reactions,the trial group was significantly lower than the control group,and the differences in all of the above indicators were statistically significant.Indirect Meta-analysis: The results showed that there was no significant difference between Fuzheng Huayu Capsules and Biejia Ruangan Tablets in reducing HA,LN,PC III,IV-C and improving HBV-DNA,and there was no significant difference in the incidence of adverse reactions,and the differences were not statistically significant.However,in terms of reducing LSM,Fuzheng Huayu Capsules were more significant than Biejia Ruangan Tablets,and the difference was statistically significant.Conclusions:(1)Traditional Meta-analysis:In terms of efficacy,either Fuzheng Huayu Capsules or Biejia Ruangan Tablets combined with entecavir significantly improved liver fibrosis indexes,liver imaging indexes,and liver function indexes compared with entecavir alone.In terms of safety,there was no difference in the safety of Fuzheng Huayu Capsules combined with entecavir compared to entecavir alone,while Biejia Ruangan Tablets combined with entecavir had a higher safety profile.(2)Indirect Meta-analysis:In terms of improving serum liver fibrosis index,improving liver function and achieving HBV-DNA conversion,there was no significant difference between Fuzheng Huayu Capsules and Biejia Ruangan Tablets,with comparable efficacy and comparable safety.Because of factors such as low sample size and low quality of literature,Fuzheng Huayu Capsules may be superior to Biejia Ruangan Tablets in terms of reducing LSM.