10种口服中成药联合化疗治疗乳腺癌的网状Meta分析  

A network Meta-analysis of 10 kinds of oral Chinese patent medicine combined with chemotherapy in treatment of breast cancer

作　　者：来保勇 吕灵艳 赵静 楚爱景 王春晖[2] 裴晓华 LAI Bao-yong;LYU Ling-yan;ZHAO Jing;CHU Ai-jing;WANG Chun-hui;PEI Xiao-hua(The Third Affiliated Hospital of Beijing University of Chinese Medicine,Beijing 100029,China;The Fangshan Hospital of Beijing University of Chinese Medicine,Beijing 102400,China;The Xiamen Hospital of Beijing University of Chinese Medicine,Xiamen 361001,China)

机构地区：[1]北京中医药大学第三附属医院,北京100029 [2]北京中医药大学房山医院,北京102400 [3]北京中医药大学厦门医院,福建厦门361001

出　　处：《中草药》2021年第21期6609-6624,共16页Chinese Traditional and Herbal Drugs

基　　金：国家自然科学基金面上项目(817743191001982)。

摘　　要：目的基于网状Meta分析方法比较10种口服中成药联合化疗治疗乳腺癌的疗效和安全性。方法检索CNKI、Wanfang、VIP、Sino Med、Pub Med、EMbase、Web of Science、Cochrane Library数据库中相关口服中成药治疗乳腺癌的随机对照试验(randomized controlled trial,RCTs),检索时间为建库至2021年1月1日。2人独立对文献进行筛选、提取数据和质量评价。采用Rev Man5.3、Stata14.0、Gemtc14.3软件进行数据分析。结果共纳入61项RCTs,涉及10种口服中成药。网状Meta分析结果显示,以化疗为共同干预措施,口服中成药改善乳腺癌Ⅰ~Ⅲ期患者客观缓解率(objective response rateORR)的疗效排序为参一胶囊>金龙胶囊>西黄丸/胶囊>平消胶囊>复方斑蝥胶囊>华蟾素胶囊>槐耳颗粒>小金片/丸;改善Ⅰ~Ⅲ期患者疾病控制率(disease control rate,DCR)的疗效排序为金龙胶囊>西黄丸/胶囊>华蟾素胶囊>平消胶囊>复方斑蝥胶囊>槐耳颗粒>小金片/丸;改善Ⅲ~Ⅳ期患者ORR的疗效排序为槐耳颗粒>西黄丸/胶囊>参一胶囊>华蟾素胶囊>平消胶囊>小金片/丸;改善Ⅲ~Ⅳ期患者DCR的疗效排序为平消胶囊>参一胶囊>西黄丸/胶囊>华蟾素胶囊>槐耳颗粒>小金片/丸;生活质量(quality of life,QOL)改善率的疗效排序为西黄丸/胶囊>槐耳颗粒>参一胶囊>华蟾素胶囊>金龙胶囊>复方斑蝥胶囊>平消胶囊;西黄丸有益于提高乳腺癌患者的疾病无进展生存期(progression free survival,PFS)和患者总生存期(overall survival,OS),平消胶囊有益于提高OS;缓解白细胞减少发生率的疗效排序为参一胶囊>槐耳颗粒>华蟾素胶囊>西黄丸/胶囊>贞芪扶正颗粒>平消胶囊>复方斑蝥胶囊>小金片/丸;减少消化道反应发生率的疗效排序为贞芪扶正颗粒>西黄丸/胶囊>槐耳颗粒和参一胶囊>平消胶囊>华蟾素胶囊>小金片/丸>复方斑蝥胶囊。结论对于Ⅰ~Ⅲ期患者,参一胶囊联合化疗改善ORR的效果显著,金龙胶囊联合�Objective To compare the efficacy and safety of 10 kinds of oral Chinese patent medicine combined with chemotherapy in the treatment of breast cancer,a network Meta-analysis was performed.Methods CNKI,Wanfang,VIP,SinoMed,PubMed,Embase,Web of Science and Cochrane Library database were searched from inception to January 1,2021.The inclusion criteria were the randomized controlled trials(RCTs)of Chinese patent medicine plus chemotherapy for breast cancer.Literature screening,data extraction,the quality assessment was independently conducted by two authors.RevMan5.3,Stata14.0 and Gemtc14.3 were used for data analysis.Results A total of 61 RCTs were eventually included,involving 10 oral Chinese patent medicines.The results of network Meta-analysis showed that,combined with chemotherapy,in terms of improving ORR(I-III stage),the order of efficacy was Shenyi Capsule(参一胶囊)>Jinlong Capsule(金龙胶囊)>Xihuang Pill/Capsule(西黄丸/胶囊)>Pingxiao Capsule(平消胶囊)>Compound Cantharis Capsule(复方斑蝥胶囊)>Cinobufagin Capsule(华蟾素胶囊)>Huaier Granule(槐耳颗粒)>Xiaojin Tablet/Pill(小金片/丸);In terms of improving DCR(I-III stage),the order of efficacy was Jinlong Capsule>Xihuang Pill/Capsule>Cinobufagin Capsule>Pingxiao Capsule>Compound Cantharis Capsule>Huaier Granule>Xiaojin Tablet/Pill;In terms of improving ORR(III-IV stage),the order of efficacy was Huaier Granule>Xihuang Pill/Capsule>Shenyi Capsule>Cinobufagin Capsule>Pingxiao Capsule>Xiaojin Tablet/Pill;In terms of improving DCR(III-IV stage),the order of efficacy was Pingxiao Capsule>Shenyi Capsule>Xihuang Pill/Capsule>Cinobufagin Capsule>Huaier Granule>Xiaojin Tablet/Pill;In terms of improving QOL,the order of efficacy was Xihuang Pill/Capsule>Huaier Granule>Shenyi Capsule>Cinobufagin Capsule>Jinlong Capsule>Compound Cantharis Capsule;Xihuang Pill/Capsule was beneficial in improving PFS and OS of breast cancer patients,Pingxiao Capsule was beneficial in improving OS of breast cancer patients;In terms of reducing the incidence rate

关 键 词：中成药 中医药 乳腺癌 网状Meta 随机对照试验 参一胶囊 金龙胶囊 西黄丸/胶囊 平消胶囊 复方斑蝥胶囊 华蟾素胶囊 槐耳颗粒 小金片/丸 贞芪扶正颗粒 养正消积 

分 类 号：R285.64[医药卫生—中药学]