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摘要：
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摘要：目的 评价布地奈德与泼尼松分别联合硫唑嘌呤治疗自身免疫性肝炎的疗效与安全性。方法 以
budesonide、prednisone、autoimmune hepatitis和randomized controlled trials为检索词，检索PubMed、
Google学术、Cochrane图书馆等数据库；以“布地奈德、泼尼松、自身免疫性肝炎、随机对照试验”
为检索词，检索中国知网、万方数据库及中国生物医学文献数据库。对纳入的随机对照文献采用
Jadad评分进行文献质量评价，对纳入的非随机对照文献采用纽卡斯尔-渥太华量表（Newcastle-Ottawa
Scale，NOS）进行文献质量评价。提取文献研究中患者治疗后的缓解情况及不良反应发生情况，采
用RevMan5.3软件进行Meta分析，比较布地奈德与泼尼松分别联合硫唑嘌呤治疗自身免疫性肝炎的缓
解率及不良反应发生率。结果 共纳入4篇文献，总计435例患者，其中布地奈德联合硫唑嘌呤组182
例，泼尼松联合硫唑嘌呤组253例。Meta分析显示，布地奈德联合硫唑嘌呤组治疗自身免疫性肝炎的
缓解率高于泼尼松联合硫唑嘌呤组（OR = 2.07，95%CI：1.36～3.15，z = 3.38，P ＜ 0.01），不良反
应发生率低于泼尼松联合硫唑嘌呤组（OR = 0.16，95%CI：0.09～0.28，z = 6.32，P ＜ 0.01）。结论
布地奈德联合硫唑嘌呤对自身免疫性肝炎的疗效优于泼尼松联合硫唑嘌呤，且治疗后不良反应发生率
低。
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Abstract: Objective To evaluate the efficacy and safety of budesonide and prednisone in combination with
azathioprine respectively in the treatment of autoimmune hepatitis. Methods “Budesonide, prednisone,
autoimmune hepatitis and randomized controlled trials in English were used as search terms in databases such
as Pubmed, Google Scholar, Cochrane Library and so on. Budesonide, prednisone, autoimmune hepatitis and
randomized controlled trials in Chinese were used as search terms in China Knowledge Network, Wanfang
Database and China Biomedical Literature Database. The included randomized controlled literatures were
evaluated by the Jadad score for literature quality, and the non-randomized controlled literatures were
evaluated by Newcastle-Ottawa scale (NOS). The relief and adverse reactions of patients after treatment in
literatures were extracted. Meta-analysis was performed by RevMan5.3 software to compare the response
rate and adverse reaction rate of budesonide and prednisone in combination with azathioprine respectively in
the treatment of autoimmune hepatitis. Results A total of 435 patients were included in 4 articles, including
182 cases in budesonide combined with azathioprine group and 253 cases in prednisone combined with
azathioprine group. Meta-analysis showed that the response rate of budesonide combined with azathioprine
in treatment of autoimmune hepatitis was higher and the incidence of adverse reaction was lower than those
of prednisone combined with azathioprine (OR = 2.07, 95%CI: 1.36～3.15, z = 3.38, P ＜ 0.01; OR = 0.16,
95%CI: 0.09～0.28, z = 6.32, P ＜ 0.01). Conclusion Budesonide combined with azathioprine is superior
to prednisone combined with azathioprine in the treatment of autoimmune hepatitis, with a low incidence of
adverse reaction.
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