Reduced Glutathione For Alcoholic Liver Disease: A Systematic Evaluation

OBJECTIVE:To evaluate the curative effect and safety of reduced glutathione for alcoholic liver diseases(ALD).METHODS:We searched PUBMED(1966～2006.10),MEDLINE(1986～2006.10), EMBASE(1989～2006.10),The Cochrane Library(Issue4,2006),The Cochrane Hepato-Biliary Group Controlled Trials Register,Chinese Biomedicine Database (1980～2006.10),China National Knowledge Infrastructure(1994～2006.10),VIP (1989～2006.10);ten Chinese medical journals and relevant academic conference proceedings have been searched by manual method.The quality evaluation of studies and the data analysis followed the methods of The Cochrane Collaboration.Metaanalysis was performed by RevMan 4.2.8 software.RESULT:Eleven studies involving 753 patients were included;four compared domestic glutathione versus imported glutathione,and four compared reduced glutathione versus placebo;and two compared reduced glutathione versus potassium magnessium aspartape;and one compared reduced glutathione versus diammonium glycyrrhizinaten.The meta-analysis showed that:①Domestic glutathione was not significantly different from imported glutathione in total effective rate,liver function,improvement of clinical symptoms and adverse effects,total effective rate[82.0%vs 83.3%;RR=0.98,95%CI(0.89,1.09)],effective rate[62.7%vs 66.0%;RR=0.95,95%CI(0.80,1.12)],adverse effect[RR=0.50, 95%CI(0.09,2.65)].②Compared with placebo group,clinical efficacy and liver function was significantly higher for reduced glutathione group,total effective rate[92.2%vs 64.5%;RR=1.43,95%CI(1.13,1.81)],effective rate[58.1%vs 21.0%;RR=2.76, 95%CI(1.90,4.00)],but there were no significant differences in adverse effects [RR=10.11,95%CI(0.52,195.01)].③Compared with potassium magnessium aspartape group,clinical efficacy and liver function was significantly higher for reduced glutathione group,total effective rate [95.0%vs 61.7%;RR=1.54,95%CI(1.25,1.90)],effective rate[85.0%vs 18.3%; RR=4.64,95%CI(2.69,7.99)],but there were no significant differences in adverse effects.④Compared with diammonium glycyrrhizinaten group,clinical efficacy and liver function was significantly higher for reduced glutathione group,total effective rate [83.3%vs 18.3%;RR=1.35,95%CI(1.04,1.74)],but there were no significant differences in adverse effects.CONLUTION:There were no significant difference in clinical efficacy and safety for domestic glutathione compared with imported glutathione;compared with placebo, potassium magnessium aspartape and diammonium glycyrrhizinaten,reduced glutathione can significantly improve clinical efficacy,liver function and no visible adverse effects emerge.