参一胶囊联合化疗治疗乳腺癌的系统评价  

Combined Shenyi-Jiaonang and chemotherapy in treatment of breast cancer: a systematic review

作　　者：王晓珊[1] 吴琦[1] 梁良[1] 

机构地区：[1]四川省医学科学院.四川省人民医院肿瘤科,四川成都610072

出　　处：《实用医院临床杂志》2012年第6期192-195,共4页Practical Journal of Clinical Medicine

摘　　要：目的评价参一胶囊联合化疗治疗女性乳腺癌的效果和安全性。方法采用Cochrane系统评价方法,检索Co-chrane图书馆(2012年第2期)、MEDLINE(1966～2012年)、CNKI(1994～2012年)、VIP(1963～2012年)、万方数据库(1994～2012年)等数据库。由3名评价者共同评价纳入研究质量,对同质研究进行Meta分析。结果共纳入4个随机对照研究、274例女性乳腺癌患者。所有纳入的4个研究均表明采用了随机的方法,但未提及分配隐藏及盲法,所有纳入研究均未进行ITT意向性分析。Meta分析显示参一胶囊联合化疗与单纯化疗相比有效率以及胃肠道反应差异无统计学意义,但在减轻化疗后白细胞减少[OR 0.26,95%CI(0.15～0.46)]以及生活质量评分(KPS评分)[OR 3.39,95%CI(1.27～9.02)]上有优势,差异有统计学意义。结论现有研究结果显示参一胶囊联合化疗未明显增加化疗有效率以及减轻胃肠道反应,但减轻了化疗后白细胞下降以及改善了患者化疗后KPS评分。由于纳入研究存在选择性偏倚和测量性偏倚的高度可能性,势必影响结果的强度,期待将来高质量的随机双盲对照试验提供高质量的证据。Objective To evaluate the efficacy and safety of Shenyi-Jiaonang combined with chemotherapy in treatment of breast cancer. Methods The Cochrane Library,MEDLINE （1966 -2012） ,CNKI （1994 -2012） ,VIP （1963 -2012） and WanFang Data-base （ 1994 - 2012） were searched. The quality of included studies was evaluated by three individual reviewers. The meta-analysis was performed for the homogeneous studies. Results Four studies involving 274 patients with breast cancer were included. All included studies used randomized control trial （RCT） , but did not report concealment of allocation and blinding. Meta analysis based on included studies showed that the combined Shenyi-Jiaonang and chemotherapy significantly improved leukopenia [ OR = 0.26,95% CI （0.15 ~ O. 46） ] and Karnofsky Performance Scale （KPS） score [ OR = 3.39,95% CI（ 1.27 -9.02） ] compared to control group. However,no significant improvement on gastrointestinal reactions was observed. Conclusion Shenyi-Jiaonang may be effective to prevent leucopenia and improve KPS score after chemotherapy, but has no significant effect on gastrointestinal reactions. Conclusions drawn from the includ- ed studies are limited because of bias in patient＇ s selection and parameter detection. Therefore, further studies with larger-scale RCT trials using Shenyi-Jiaonang in the treatment of breast cancer are needed.

关 键 词：参一胶囊 乳腺癌 化疗 系统评价 

分 类 号：R979.19[医药卫生—药品] R163[医药卫生—药学]