鸦胆子油乳治疗恶性胸腔积液的Meta分析  

Brucea Javanica Oil Emulsion in Treatment of Malignant Pleural Effusion: A Meta-Analysis

作　　者：魏孔萍[1,2] 王其团 王启荣[1] 魏孔源[1] 金艳铃 孙钰[1] 邵莉莉[1] 王权[1] 田金徽[1] 

机构地区：[1]兰州大学循证医学中心,兰州730000 [2]兰州大学第二医院儿科,兰州730000 [3]浙江九旭药业有限公司学术部,浙江金华321016

出　　处：《中国循证医学杂志》2014年第10期1263-1269,共7页Chinese Journal of Evidence-based Medicine

摘　　要：目的系统评价鸦胆子油乳联合/不联合顺铂治疗恶性胸腔积液的疗效和安全性。方法计算机检索PubMed、The Cochrane Library(2013年第6期)、EMbase、CBM、WanFang Data、VIP和CNKI数据库,查找关于鸦胆子油乳联合/不联合顺铂治疗恶性胸腔积液的随机对照试验(RCT),检索时限均为从建库至2013年6月。由2位评价者按纳入与排除标准独立筛选文献、提取资料并评价纳入研究的方法学质量后,采用RevMan 5.1软件进行Meta分析。结果共纳入25个RCT,1 620例患者。Meta分析结果显示:与单用顺铂相比,顺铂联合鸦胆子油乳注射液在临床有效率[RR=1.45,95%CI(1.34,1.57),P<0.00001]、生活质量改善[RR=1.36,95%CI(1.18,1.56,P<0.0001)]、骨髓抑制发生率[OR=0.31,95%CI(0.22,0.42),P<0.00001]和消化道反应发生率[OR=0.36,95%CI(0.24,0.54),P<0.00001]方面更优,其差异均有统计学意义;与单用顺铂相比,单用鸦胆子油乳注射液在临床有效率[RR=1.26,95%CI(1.14,1.40),P<0.00001]、生活质量改善[RR=1.23,95%CI(1.04,1.45),P=0.02]、骨髓抑制发生率[OR=0.07,95%CI(0.04,0.14),P<0.00001]、消化道反应发生率[OR=0.19,95%CI(0.10,0.35),P<0.00001)]和发热情况[OR=0.18,95%CI(0.08,0.40),P<0.0001]方面更优,且差异均有统计学意义。结论现有证据表明,鸦胆子油乳能提高恶性胸腔积液患者的化疗效果。鉴于纳入研究的质量普遍偏低,上述结论尚需要开展更多大样本的高质量研究加以验证。Objective To systematically review the efficacy and safety of brucea javanica oil emulsion with/without cisplatin in the treatment of malignant pleural effusion （MPE）. Methods We electronically search PubMed, The Cochrane Library （Issue 6, 2013）, EMbase, CBM, WanFang Data, VIP and CNKI to collect randomized controlled trial about brucea javanica oil emulsion for MPE from the establishment dates to June 2013. According to the inclusion and exclusion criteria, two reviewers independently screened literature, extracted data, and assessed the methodological quality of included stud- ies. Then meta-analysis was performed using RevMan 5.1 software. Results A total of twenty-five RCTs involving 1 620 patients were included. The results of meta-analysis showed that： compared with using cisplatin alone, brucea javanica oil emulsion plus cisplatin could improve clinical efficiency （RR=1.45, 95%CI 1.34 to 1.57, P〈0.000 01） and patients＇ quality of life （RR=1.36, 95%CI 1.18 to 1.56, P〈0.000 1）, and relieved the incidences of bone marrow depression （OR=0.31, 95%CI 0.22 to 0.42, P〈0.000 01） and digestive tract reaction （OR=0.36, 95%CI 0.24 to 0.54, P〈0.000 01,） and fever （OR=0.18, 95%CI 0.08 to 0.40, P〈0.000 1）. Conclusion Current evidence indicates that brucea javanica oil emulsion could improve chemotherapy effects MPE. However, due to the limited quality oft.he included studies, more high quality studies with large sample size are needed to verify the conclusion.

关 键 词：鸦胆子油乳 恶性胸腔积液 META分析 系统评价 随机对照试验 

分 类 号：R273[医药卫生—中西医结合]