复方苦参注射液联合长春瑞滨和顺铂治疗晚期非小细胞肺癌的系统评价  

Systematic review of Yanshu injection plus vinorelbine and cisplatin treatment of non-small cell lung cancer

作　　者：张东明 单利[2] 张琰[2] 朱文忠 马向荣 马文辉 李小琴 牛宏英 杜炜 赵兰婷 张涛[2] 

机构地区：[1]平凉市第二人民医院呼吸内科,甘肃平凉744000 [2]新疆医科大学附属肿瘤医院内一科,新疆乌鲁木齐830011

出　　处：《临床荟萃》2011年第20期1774-1779,共6页Clinical Focus

摘　　要：目的系统评价长春瑞滨联合顺铂(vinorelbine combined cisplatin,NP方案)加复方苦参(岩舒)注射液治疗晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的临床疗效及安全性。方法计算机检索中国期刊全文数据库、中文科技期刊全文数据库、中国生物医学文献光盘数据库、万方数据库、PubMed及the Cochrane Library等,辅助手工检索相关期刊杂志,收集岩舒注射液联合NP方案治疗NSCLC的随机对照试验(randomized controlledtrials,RCTs);由两名研究员独立按照纳入排除标准选择RCTs,进行质量评价后提取数据并采用Cochrane系统评价软件RevMan5.0进行Meta分析。结果共纳入10项研究,包括726例晚期NSCLC患者,所有研究均报道采用了随机对照的研究方法,但未详细报道是否采用分配隐藏及双盲。Meta分析结果显示,与单纯NP方案化疗比较,岩舒注射液联合NP方案对晚期NSCLC患者进行治疗,可以提高化疗有效率(RR=1.33,95%CI=1.10～1.59,P<0.01)、改善患者生活质量(RR=1.69,95%CI=1.39～2.05,P<0.01)、减少骨髓抑制的发生(RR=0.08,95%CI=0.72～0.88,P<0.01)、降低胃肠不良反应(RR=0.75,95%CI=0.68～0.84,P<0.01)以及有效缓解癌痛(RR=1.97,95%CI=1.54～2.51,P<0.01)。结论岩舒注射液联合NP方案可以提高NSCLC治疗的有效率、改善患者生活质量、减少骨髓抑制和胃肠反应等化疗造成的不良反应及有效缓解癌痛,更易为晚期NSCLC患者所接受,值得进一步研究及临床推广。但由于纳入研究方法学质量不高,势必影响结果的论证程度,故此结论有待更多高质量及大样本的随机双盲对照试验提供高质量的证据。Objective To systematically evaluate the clinical efficacy and safety of vinorelbine combined with visplatin（NP regimen） and Yanshu injection cures for non-small cell lung cancer（NSCLC） in the later period. Methods With the automatic search of CNKI,VIP,CBM,Wanfang,PubMed and the Cochrane Library,we searched some related journals and magazines in the field,to collect randomized control trials（RCTs） that vonorelbine combined with cisplatin cures for NSCLC.Two researchers selected RCTs independently by the standard of exclusion,assessed the quality,extracted data,and analyzed with the aid of Revman5.0. Results Ten RCTs were adopted,including 726 terminal patients of NSCLC.It was reported that all of the researches adopted the method of randomized control,but it was not reported in detail whether allocation concealment and bi-blind were used.Meta analyses showed that Yanshu injection plus NP can improve the effect of chemotherapy（RR=1.33,95%CI=1.10-1.59,P0.01）,advance the living standard of patients（RR=1.69,95%CI=1.39-2.05,P0.01）,reduce the occurrence of myelosuppression（RR=0.08,95%CI=0.72-0.88,P0.01）,lower the stomach intestine reaction（RR=0.75,95%CI=0.68-0.84,P0.01）. Conclusion Yanshu injection plus NP can improve the efficiency in the treatment of NSCLC and the living standard of patients,reduce myelosuppression and stomach intestine reaction,etc,which are resulted from chemotherapy,and relieve the suffering of cancer.Therefore,it is easier for terminal patients of NSCLC to accept,and necessary for further research and clinical spread.However,the poor quality of research method restricted the validity of results,so more high-quality and large-sample studies are needed.

关 键 词：癌 小细胞肺 植物药 长春瑞滨 顺铂 治疗 系统评价 

分 类 号：R734.2[医药卫生—肿瘤]