复方苦参注射液辅助治疗老年肿瘤患者胸腔积液疗效和安全性的系统评价
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篇名: | 复方苦参注射液辅助治疗老年肿瘤患者胸腔积液疗效和安全性的系统评价 |
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摘要: | 目的:系统评价复方苦参注射液辅助治疗老年恶性肿瘤胸腔积液的疗效和安全性,为其临床应用提供循证参考。方法:计算机检索PubMed、EMBase、Medline、Cochrane图书馆、中国期刊全文数据库、中文科技期刊数据库、万方数据库,收集顺铂注射液、注射用重组人白细胞介素(IL)-2等药物联合复方苦参注射液(试验组)对比单独使用顺铂注射液、注射用重组人IL-2等药物(对照组)胸腔灌注治疗老年患者恶性胸腔积液的疗效(有效率、完全缓解率、生活质量改善率)和安全性(胸痛发生率、胃肠道不良反应发生率)的随机对照试验(RCT),对符合纳入标准的临床研究进行资料提取,并采用Cochrane系统评价员手册5.1.0进行质量评价后,采用Rev Man 5.2统计软件进行Meta分析。结果:共纳入7项RCT,合计522例患者。Meta分析结果显示,试验组患者有效率[RR=1.33,95%CI(1.20,1.48),P<0.001]、完全缓解率[RR=1.77,95%CI(1.40,2.24),P<0.001]、生活质量改善率[RR=4.61,95%CI(2.68,7.93),P<0.001]均显著高于对照组,胸痛发生率[RR=0.35,95%CI(0.21,0.59),P<0.01]、胃肠道不良反应发生率[RR=0.32,95%CI(0.20,0.51),P<0.001]均显著低于对照组,差异均有统计学意义。结论:顺铂、IL-2等药物联合复方苦参注射液对比单独使用顺铂注射液、注射用重组人IL-2等药物胸腔灌注治疗老年恶性胸腔积液有助于提高有效率、完全缓解率提高患者生存质量;同时,可显著降低胸痛及胃肠道等不良反应的发生。 |
ABSTRACT: | OBJECTIVE: To systematically review the efficacy and safety of adjuvant therapy of Compound kushen injection for pleural effusion of elderly patients with malignant cancer, and to provide evidence-based reference for clinical treatment. METHODS: Retrieved from PubMed, EMBase, Medline, Cochrane library, CJFD, VIP and Wanfang database, RCTs about therapeutic efficacy (response rate, complete remission rate, rate of life quality improvement) and safety (the incidence of chest pain and gastrointestinal ADR) of cisplatin injection, IL-2 injection or other drugs combined with Compound kushen injection (trial group) versus cisplatin injection, IL-2 injection or other drugs alone (control group) in the treatment of pleural effusion of elderly patients with malignant cancer were collected. Meta-analysis was conducted by using Rev Man 5.2 statistical software after data extraction of clinical studies met inclusion criteria and quality evaluation with Cochrane system evaluator manual 5.1.0. RESULTS: There were totally 7 RCTs, involving 522 patients. Results of Meta-analysis showed that the response rate [RR=1.33, 95%CI (1.20,1.48), P<0.001], complete remission rate [RR=1.77, 95%CI (1.40,2.24), P<0.001], rate of life quality improvement [RR=4.61, 95%CI (2.68, 7.93), P<0.001] in trial group were significantly higher than control group. The incidence of chest pain [RR=0.35, 95%CI (0.21,0.59), P<0.01] and gastrointestinal ADR [RR=0.32, 95%CI (0.20,0.51), P<0.001] in trial group were significantly lower than control group, with statistical significance. CONCLUSIONS: Cisplatin, IL-2 or other drugs combined with Compound kushen injection versus cisplatin injection, IL-2 injection or other drugs alone in treatment of elderly malignant pleural effusion can improve response rate, complete remission rate and quality of life, at the same time, can reduce the occurrence of chest pain and gastrointestinal ADR significantly. |
期刊: | 2018年第29卷第17期 |
作者: | 吴惠珍,邱学佳,董占军,刘洪涛 |
AUTHORS: | WU Huizhen,QIU Xuejia,DONG Zhanjun,LIU Hongtao |
关键字: | 复方苦参注射液;老年患者;恶性肿瘤;胸腔积液;疗效;安全性;系统评价 |
KEYWORDS: | Compound kushen injection; Elderly patients; Malignant cancer; Pleural effusion; Efficacy; Safety; Systematic review |
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