复方苦参注射液联合铂类化疗药物治疗中晚期胃癌的Meta分析  

Meta analysis of compound matrine injection combined with cisplatin chemotherapy for advanced gastric cancer

作　　者：黄思夏[1,2] 范文斌[1,2] 刘鹏[1,2] 田金徽[1] 

机构地区：[1]兰州大学循证医学中心基础医学院,甘肃兰州730000 [2]兰州大学第二临床医学院,甘肃兰州730000

出　　处：《中国中药杂志》2011年第22期3198-3202,共5页China Journal of Chinese Materia Medica

基　　金：兰州大学中央高校基本科研业务费专项(lzujbky-2011-133)

摘　　要：目的:系统评价复方苦参注射液联合铂类药物治疗晚期胃癌的临床疗效和安全性。方法:计算机检索CochraneLibrary,PubMed,EMBAS,中国生物医学文献数据库,中国期刊全文数据库,中文科技期刊全文数据库,检索时间从各数据库建库至2011年1月25日;同时辅助其他检索,纳入复方苦参注射液联合铂类化疗药物治疗中晚期胃癌的随机对照试验(ran-domized controlled trials,RCTs)。2名评价者独立评价纳入研究的质量并提取资料,并用RevMan 5.0软件进行统计分析。结果:共纳入10篇RCTs,Meta分析结果显示:与单纯含铂类化疗药物相比,复方苦参注射液联合铂类化疗药物可以提高临床受益率(OR=1.99,95%CI:1.26～3.13,P<0.05)和生活质量(OR=3.83,95%CI:2.38～6.15,P<0.001);减少白细胞下降(OR=0.44,95%CI:0.32～0.62,P<0.001)、血小板下降(OR=0.40,95%CI:0.26～0.60,P<0.001)和肝功能下降(OR=0.33,95%CI:0.15～0.75,P<0.01),提高CD3(MD=2.96,95%CI:1.72～4.20,P<0.001),CD4(MD=9.04,95%CI:7.87～10.20,P<0.001),CD4/CD8(MD=0.47,95%CI:0.41～0.54,P<0.001)和NK细胞水平(MD=5.90,95%CI:4.53～7.26,P<0.001),降低恶心呕吐等胃肠道反应(OR=0.32,95%CI:0.16～0.63,P=0.001)。结论:复方苦参注射液联合铂类化疗药物可提高胃癌治疗的临床受益率,改善骨髓抑制,降低化疗产生的不良反应,减少肝功能下降,提高患者免疫功能并提高患者生活质量,值得临床推广使用。Objective： To assess the efficacy and safety of compound matrine injection combined with cisplatin chemotherapy for advanced gastric cancer.Method： It was searched relevant randomized Controlled trials（RCTs） from Cochrane Library,PubMed,EMBASE,CBM,and CNKI etc.The search was finished in February 11,2010.And it was traced the related references and experts in this field,besides it was also communicated with other authors in order to obtain some certain information that had not been found.RCTs of compound matrine injection combined with cisplatin chemotherapy versus cisplatin chemotherapy for advanced gastric cancer were included.it was evaluated the quality of these included studies and analyzed data by Cochrane Collaboration′s RevMan 5.0 software.Result： Ten RCTs were included meta analysis results suggested that compared with chemotherapy alone,the combination had a statistically significant benefit in healing efficacy（OR=1.99,95%CI：1.26-3.13,P〈0.05）and improving quality of life（OR=3.83,95%CI：2.38-6.15,P〈0.001）.Besides,the combination also had a statistically significant benefit in myelosuppression,white blood cell（OR=0.44,95%CI：0.32-0.62,P〈0.001）,hematoblast（OR=0.40,95%CI：0.26-0.60,P〈0.001）,liver function（OR=0.33,95%CI：0.15-0.75,P〈0.05）and in reducing the gastroenteric reaction（OR=0.32,95%CI：0.16-0.63,P=0.001）,decreasing the of CD3（MD=2.96,95%CI：1.72-4.20,P〈0.001）,CD4（MD=9.04,95%CI：7.87-10.20,P〈0.001）,CD4/CD8（MD=0.47,95%CI：0.41-0.54,P〈0.001）and NK cells（MD=5.90,95%CI：4.53-7.26,P〈0.001）.Conclusion： Compared with cisplatin chemotherapy,compound matrine injection combined with cisplatin chemotherapy can significantly improve the efficiency,QOL and myelosuppression,and reduce adverse events.

关 键 词：复方苦参注射液 化疗 胃癌 META分析 

分 类 号：R273[医药卫生—中西医结合]