中药防治头颈部恶性肿瘤患者放射性口腔黏膜炎的Meta分析  

Chinese Medicine for the Prevention and Treatment of Radioactive Oral Mucositis in Patients with Head and Neck Cancer:A Meta-analysis

作　　者：赵悦欣 鹿红[1] 陈乐君 林洋 于大海[1] ZHAO Yue-xin;LU Hong;CHEN Le-jun;LIN Yang;YU Da-hai(Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029 Jiangsu,China)

机构地区：[1]南京中医药大学附属医院,江苏南京210029

出　　处：《中医肿瘤学杂志》2023年第1期72-77,共6页Journal of Oncology in Chinese Medicine

基　　金：江苏省中医药科技发展计划项目(编号:YB2020009);江苏省中医院科技项目(编号:Y2021ZR07);江苏省研究生科研创新计划项目(编号:KYCX22_1914)。

摘　　要：目的采用Meta分析方法,对中药防治头颈部肿瘤患者急性放射性口腔黏膜炎的临床疗效进行系统性回顾,为临床应用提供参考。方法计算机检索从2011年1月至2021年11月间PubMed、Embase、CochraneLibrary、CNKI、Wanfang、VIP、CMB等国内外主要数据库,筛选出关于中药防治放射性口腔黏膜炎的临床随机对照试验(RandomizedControlledTrial,RCT)研究。通过Cochrane系统评价和Jadad量表对文献进行质量评价,采用Revman软件对符合标准的随机对照试验进行Meta分析,进而探讨中药对放射性口腔黏膜炎的防治作用。结果共纳入14项随机对照试验,涉及1013例患者,Meta分析结果表明,试验组急性RTOM发生时间明显迟于对照组[MD=4.49,95%CI(2.03,6.94),P=0.0003],Ⅲ级~Ⅳ级RTOM发生率明显低于对照组[OR=0.27,95%CI(0.14,0.52),P<0.0001],治疗有效率较对照组明显升高[OR=6.22,95%CI(2.93,13.17),P<0.0001]。结论头颈部肿瘤患者放射治疗期间运用中药可以延缓RTOM出现时间,降低Ⅲ级~Ⅳ级RTOM的发生率,在治疗期间使用中药的治疗有效率明显高于单纯的西医治疗。中药可有效防治放射性口腔黏膜炎,值得临床广泛使用。Objective To systematically evaluate the clinical efficacy of Chinese medicine for the prevention and treatment of acute radioactive oral mucositis(ROM)in patients with head and neck tumors by using meta analysis,so as to provide reference for the clinical application.Methods Computer search for PubMed,Embase,Cochrane Library,CNKI,Wanfang,VIP,and CMB from January 2011 to November 2021 were conducted to retrieve the clinical randomized controlled trials(RCTs)of the prevention and treatment of radioactive oral mucositis with Chinese medicine.The quality of the literature was evaluated by Cochrane systematic evaluation and Jadad scale,and meta-analysis was performed for the randomized controlled trials that met the criteria using RevMan software,and the then effect of Chinese medicine on the prevention and treatment of radioactive oral mucositis was evaluated.Results A total of 14 RCTs were included into the study,involving 1013 cases.Meta analysis showed that the onset time for acute TOM in the trial group was significantly later than that in the control group[MD=4.49,95%CI(2.03,6.94),P=0.0003],the incidence of gradeⅢ-ⅣROM was significantly lower[OR=0.27,95%CI(0.14,0.52),P<0.0001]and the effective rate was significantly higher than that in the control group[OR=6.22,95%CI(2.93,13.17),P<0.0001].Conclusion The use of Chinese medicine during radiation therapy for patients with head and neck tumors can delay the appearance of ROM and reduce the incidence of gradeⅢ-ⅣROM,and exerts stronger therapeutic efficiency than western medicine alone.The results indicated that Chinese medicine can effectively prevent and treat radiation oral mucositis and is worthy of expanding its clinical application.

关 键 词：放射性口腔黏膜炎 中医药 临床疗效 META分析 随机对照试验 

分 类 号：R273[医药卫生—中西医结合] R739.91[医药卫生—中医肿瘤科]