复方苦参注射液联合含奥沙利铂化疗方案治疗大肠癌疗效与安全性的系统评价
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篇名: 复方苦参注射液联合含奥沙利铂化疗方案治疗大肠癌疗效与安全性的系统评价
TITLE:
摘要: 目的:系统评价复方苦参注射液联合含奥沙利铂化疗方案治疗大肠癌的疗效和安全性,为临床提供循证参考。方法:计算机检索中国期刊全文数据库、万方数据库、中国生物医学文献数据库、中文科技期刊数据库、PubMed、Cochrane图书馆,收集复方苦参注射液联合含奥沙利铂化疗方案(试验组)对比常规化疗方案(对照组)治疗大肠癌的随机对照试验(RCT),提取资料并依据改良的Jadad量表进行质量评价后,采用Rev Man 5.3统计软件进行Meta分析。结果:最终纳入33项RCT,合计2 801例患者。Meta分析结果显示,试验组患者近期有效率[RR=1.34,95%CI(1.24,1.46),P<0.001]、功能状态(KPS)评分改善率[RR=1.87,95%CI(1.65,2.14),P<0.001]、CD4+/CD8+[WMD=0.49,95%CI(0.26,0.72),P<0.001]、CD4+水平 [WMD=10.34,95%CI(7.00,13.69),P<0.001]、CD3+水平[WMD=5.85,95%CI(4.07,7.62),P<0.001]、自然杀伤细胞水平 [WMD=3.52,95%CI(1.76,5.27),P<0.001]、白细胞介素(IL)-2水平 [WMD=12.96,95%CI(10.39,15.53),P<0.001]显著高于对照组, CD8+水平[WMD=-5.89,95%CI(-11.39,-0.40),P=0.04]、IL-10水平[WMD=-21.04,95%CI(-29.15,-12.94),P<0.001]、恶心呕吐发生率[RR=0.72,95%CI(0.67,0.78),P<0.001]、白细胞减少发生率[RR=0.52,95%CI(0.45,0.61),P<0.001]、肝功能异常发生率[RR=0.63,95%CI(0.53,0.74),P<0.001]、周围神经毒性发生率[RR=0.77,95%CI(0.64,0.92),P=0.005]显著低于对照组,差异均有统计学意义。结论:复方苦参注射液联合含奥沙利铂化疗方案治疗大肠癌疗效优于单纯化疗,可以提高患者生存质量,改善免疫功能,降低化疗引起的不良反应。
ABSTRACT: OBJECTIVE: To systematically review the efficacy and safety of Compound kushen injection combined with oxaliplatin-based chemotherapy regimen in the treatment of colorectal cancer, and provide evidence-based reference for clinic. METHODS: Retrieved from CJFD, Wanfang Database, CBM, VIP, PubMed and Cochrane Library,randomized controlled trials (RCT) about Compound kushen injection combined with oxaliplatin-based chemotherapy (test group) versus conventional chemotherapy (control group) in the treatment of colorectal cancer were collected. Meta-analysis was performed by using Rev Man 5.3 software after data extraction and quality evaluation by modified Jadad scale. RESULTS: Totally 33 RCTs were included, involving 2 801 patients. Results of Meta-analysis showed the short-term effective rate [RR=1.34,95%CI(1.24,1.46),P<0.001], improvement rate of KPS score[RR=1.87,95%CI(1.65,2.14),P<0.001], CD4+/CD8+ values [WMD=0.49,95%CI(0.26,0.72),P<0.001],CD4+ level[WMD=10.34,95%CI(7.00,13.69),P<0.001],CD3+ level[WMD=5.85,95%CI(4.07,7.62),P<0.001]、nature kill cell level [WMD=3.52,95%CI(1.76,5.27),P<0.001]、IL-2 level [WMD=12.96,95%CI(10.39,15.53),P<0.001] in test group were significantly higher than control group, CD8+ level[WMD=-5.89,95%CI(-11.39,-0.40),P=0.04],IL-10 level [WMD=-21.04,95%CI(-29.15,-12.94),P<0.001],the incidence of nausea and vomiting [RR=0.72,95%CI(0.67,0.78),P<0.001],white blood cell reduction [RR=0.52,95%CI(0.45,0.61),P<0.001],abnormal liver function [RR=0.63,95%CI(0.53,0.74),P<0.001],peripheral neurotoxicity [RR=0.77,95%CI(0.64,0.92),P<0.001] was significantly lower than control group, with statistical significances. CONCLUSIONS: Compound kushen injection combined with oxaliplatin-based chemotherapy is superior to conventional chemotherapy alone in the treatment of colorectal cancer, which can improve life quality and immune functions, reduce the adverse reactions induced by chemotherapy.
期刊: 2017年第28卷第3期
作者: 吴驻林,谭婉君,连宝涛,彭立生
AUTHORS: WU Zhulin,TAN Wanjun,LIAN Baotao,PENG Lisheng
关键字: 复方苦参注射液;化疗;大肠癌;系统评价;疗效;安全性
KEYWORDS: Compound kushen injection; Chemotherapy; Colorectal cancer; Systematic review; Efficacy; Safety
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