3种温经通络方防治慢性奥沙利铂外周神经毒性疗效的网状荟萃分析  

Efficacy of 3 Kinds of Wenjing Tongluo Prescriptions in Preventing Chronic Oxaliplatin-Induced Peripheral Neurotoxicity: A Network Meta-Analysis

作　　者：丁蓉[1] 余佳霖 魏国利[1] 汪悦[2] 胡灿红[1] 钱峻 霍介格[1] Ding Rong;Yu Jialin;Wei Guoli;Wang Yue;Hu Canhong;Huo Jiege(Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine,Nanjing 210028,China;Nanjing University of Chinese Medicine,Nanjing 210023,China)

机构地区：[1]南京中医药大学附属中西医结合医院,南京210028 [2]南京中医药大学第一临床医学院,南京210023

出　　处：《世界科学技术-中医药现代化》2019年第7期1474-1480,共7页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：国家自然科学基金委员会青年项目(81503568):基于TRP通道探讨当归四逆汤对奥沙利铂致周围神经毒性机制的研究,负责人:丁蓉;中央级公益性科研院所基本科研业务费专项资金资助课题(ZZ08080014):黄芪桂枝五物配方颗粒缓解奥沙利铂相关周围神经毒性的临床评价,负责人:霍介格;江苏省中医药局面上项目(YB2015035):基于TRPs通道探讨当归四逆汤对奥沙利铂神经毒性作用的研究,负责人:霍介格

摘　　要：目的 采用网状荟萃分析的方法比较三种温经通络方(黄芪桂枝五物汤、当归四逆汤、阳和汤)防治慢性奥沙利铂外周神经毒性(OIPN)的疗效,为临证治疗提供参考。方法 全面检索CNKI、维普、万方、PubMed、Cochrane图书馆、EM base收录的3种温经通络方防治慢性奥沙利铂外周神经毒性的随机对照临床研究文献,检索时限均从2005年1月1日-2018年12月31日,提取资料并进行质量评价后采用ADDIS 1. 16. 8软件进行网状荟萃分析。结果 根据纳入和排除标准共纳入10项研究中的579例患者。网状荟萃分析显示三种中药汤剂与对照组相比,均能降低奥沙利铂不良反应之一神经毒性的发生率和严重神经毒性发生率,防治OIPN发生率的概率排序为黄芪桂枝五物汤、当归四逆汤、阳和汤;防治严重OIPN发生率的概率排序依次为:当归四逆汤、黄芪桂枝五物汤、阳和汤。结论 口服黄芪桂枝五物汤、当归四逆汤、阳和汤都可减少慢性奥沙利铂神经毒性的发生,前两者优于阳和汤。受纳入样本质量的局限,需进一步开展多中心、大样本、高质量的随机临床试验研究。Objective To compare the efficacy of Wenjing Tongluo prescriptions(Huangqi Guizhi Wuwu Decoction(HQGZWWT),Danggui Sini Decoction(DGSNT),Yanghe Decoction(YHT))in preventing chronic oxaliplatin-induced peripheral neurotoxicity(OIPN)by applying network Meta-analysis,and to provide evidence-based reference for clinical treatment.Methods Studies were identified by searching CNKI,WanFang,VIP,PubMed,Cochrane libraries and EMbase database from date of January 2005 to November 2018.Randomized controlled trials(RCT)that evaluated efficacy of 3 kinds of Wenjing Tongluo Prescriptions in preventing chronic OIPN were included.Network Meta-analysis was performed by using ADDIS 1.16.8 after extracting data and evaluating quality.Results Totally,10 RCTs involving 579 patients were included.The results of network Meta-analysis showed that there were statistically significant differences incidences of OIPN and severe OIPN between 3 kinds of Wenjing Tongluo prescriptions and control group.Probability ranking results showed efficacy in preventing incidence of OIPN was HQGZWWT,DGSNT,YHT and efficacy in preventing incidence of severe OIPN was DGSNT,HQGZWWT,YHT.Conclusion Results indicated that,3 kinds of Wenjing Tongluo prescriptions are effective to prevent chronic OIPN.The first 2 are better than Yanghe Decoction.Due to the limitation of the quality of the included samples,further studies on multi-center,large-sample and high-quality RCTs are needed.

关 键 词：温经通络方 奥沙利铂 外周神经毒性 网状荟萃分析 

分 类 号：R289.5[医药卫生—方剂学]