中药注射剂联合放疗治疗鼻咽癌疗效及安全性的网状Meta分析  

Effectiveness and safety of Chinese medical injections in combination with radiotherapy for esophageal carcinoma:a network meta analysis

作　　者：杨青廷 熊文婧[2] 旷满华 刘也[1] 李国峰[1] 让蔚清[1] 周平坤[3] 

机构地区：[1]南华大学,湖南衡阳421001 [2]北京中医药大学基础医学院循证医学中心 [3]中国人民解放军军事医学科学院

出　　处：《实用预防医学》2016年第6期663-667,共5页Practical Preventive Medicine

基　　金：国家863项目(2012AA063501);疾病控制评价重点实验室建设经费资助(NHSYS04);公共卫生与预防医学湖南省"十二五"重点学科建设经费

摘　　要：目的采用网状meta分析，以单纯放疗为对照干预措施比较中药注射剂联合放疗治疗鼻咽癌的疗效及安全性。方法检索Cochrane Library、PubMed、EMbase、CBM、CNKI、维普数据库，收集所有中药注射液联合放疗治疗鼻咽癌的随机对照试验（RCTs）和半随机对照试验（CCT），按预先制定的纳入与排除标准筛选和纳入，并对纳入文献质量进行评价，数据采用Microsoft Excel软件加载NetMetaXL宏命令调用WinBUGS1．4．3软件进行分析。结果共纳入9种中药注射剂，23个研究，网状Meta分析结果显示，与单纯放疗相比，完全有效率方面OR康莱特注射剂=3．42，95％CI（1．60，7．11）；DR康艾注射剂=9．18，95％CI（1．40，100．50），优于对照组，其余差异无统计学意义。Ⅱ-Ⅳ级口腔黏膜炎方面，OR叁芪扶注射剂=0．12，95％CI（0．02，0．63）；OR华蟾素注射剂=0．20，95％CI（0．04，0．93）；OR康艾注射剂=0．25，95％CI（0．06，0．98）；OR艾迪注射剂=0．31，95％CI（0．14，0．72）；OR康莱特注射剂=0．35，95％CI（0．12，0．97）；OR复方苦参注射剂=0．50，95％CI（0．26，0．93），优于对照组，其余差异无统计学意义。结论在完全有效率方面，康莱特注射剂效果最好的可能性最大，在Ⅱ～Ⅱ口腔黏膜炎发生率方面，参芪扶正注射剂效果最好的可能性最大，该结论有待更多高质量、大样本、长期随访的RCTs进一步验证。Objiective To systematically evaluate the efficacy and safety of 9 Chinese medical injections in combination with radiotherapy for esophageal carcinoma , with simple radiotherapy as control interventions and by network meta-analysis. Methods The Cochrane Library, PubMed, EMbase, CBM, CNKI, VIP and WanFang Data were retrieved to collect the randomized controlled trials（RCTs） and controlled clinical trais（CCTs） of Chinese medical injections combined with radiation treatment for esophageal carcinoma. The trials were screened according to the pre-established inclusion and exclusion criteria , and the quality of the related articles were assessed. Data were analyzed by using the WinBUGS1.4.3 software that Microsoft Excel software commanded to load the NetMetaXL. Results A total of 23 RCTs and 9 Chinese medical injections were involved. The network meta-analysis showed that in full efficiency respect, compared with radiotherapy alone, Kanglaite Injection and Kang＇ ai Injection were superior, with the ORs （95%CI） of 3.42（ 1.60-7.11）and 9.18（ 1.40-100.50）, respectively. For the grade Ⅰ - Ⅳ oral mucosa , Shenqifuzheng Injection （OR=0.12, 95%CI： 0.02-0.63） , Cinobufacini Injection （OR=0.20, 95%CI： 0.04-0.93）, Kang＇ ai Injection （0R=0.25, 95%CI： 0.06-0.98） , Aidi Injection （ OR= 0.31, 95%CI： 0. 14-0.72）, Kanglaite Injection （ OR = 0.35, 95%CI： 0.12-0.97） and Compound Matrine Injection （OR=0.50, 95%CI： 0.26-0.93） showed statistical significance （P〈0.05）. Conclusions As for safety and effectiveness, Kanglaite Injection is most likely the best choice for treatment of esophageal carcinoma by combined Chinese medical injections and radiotherapy. Shenqifuzheng Injection is probably the most effective in reducing the incidence of grade Ⅱ-Ⅳ oral mucositis. Due to the poor quality of included studies,it still needs RCTs with larger samples, higher quality and longer follow-up to verify.

关 键 词：中药注射剂 鼻咽癌 网状meta分析 系统评价 随机对照试验 

分 类 号：R739.63[医药卫生—肿瘤]