温阳利水法治疗恶性腹腔积液的Meta分析  

Meta-analysis of the Treatment of Malignant Abdominal Effusion by the Yang-warming and Water-excerting Method

作　　者：胡亚琪 孔林翎 高磊 郝万山[3] 姜敏[2] HU Ya-qi;KONG Lin-ling;GAO Lei;HAO Wan-shan;JIANG Min(Beijing University of Chinese Medicine,Beijing 100029,China;The Oriental Hospital of Beijing University of Chinese Medicine,Beijing 100078,China;School of Basic Medical Sciences,Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学东方医院,北京100078 [3]北京中医药大学基础医学院,北京100029

出　　处：《云南中医中药杂志》2023年第8期31-40,共10页Yunnan Journal of Traditional Chinese Medicine and Materia Medica

基　　金：国家自然科学基金面上项目(82174458);北京中医药大学基本科研业务费重点攻关项目(2020-JYB-ZDGG-123);国家重点研发计划项目(2018YFC1705100)。

摘　　要：目的 系统评价温阳利水法治疗恶性腹腔积液的疗效。方法 全面检索PubMed, Embase, Cochrane Library,中国知网(CNKI),维普数据库(VIP),万方数据库,中国生物医学数据库,检索时间从建库至2021年12月1日,由2名研究人员依据纳入排除标准独立进行文献筛选及资料提取,使用Review Manager 5.4软件进行Meta分析。结果 共纳入16项随机对照试验,共计1180例患者。Meta分析显示,温阳利水法治疗恶性腹腔积液能够提高治疗的有效率(RR=1.42;95%CI:1.31,1.54;P=0.00001),改善患者KPS评分(MD=8.50;95%CI:7.22,9.78;P<0.00001),提高免疫功能(CD3^(+)T淋巴细胞MD=6.37;95%CI:5.35,7.38;P<0.00001;CD4^(+)T淋巴细胞MD=9.54;95%CI:8.51,10.57;P<0.00001;CD8^(+)T淋巴细胞MD=-3.78,95%CI:-4.65,-2.91,P<0.00001;CD4^(+)/CD8^(+)T淋巴细胞MD=0.64,95%CI:0.52,0.75,P<0.00001),降低腹腔积液量(MD=-128.80;95%CI:-147.97,-109.62;P<0.00001),提高生存率(1年生存率RR=1.34,95%CI:1.15,1.55,P=0.00001;3年生存率RR=1.90,95%CI:1.33,2.70,P=0.0004)。安全性方面,温阳利水法能减少消化道反应(P=0.01)、骨髓抑制(P=0.003)、肝肾功能异常(P=0.02)不良事件的发生。结论 温阳利水法治疗恶性腹腔积液能够提高临床治疗有效率和生存率,改善KPS评分和免疫功能,并具有良好的安全性。Objective:To systematically evaluate the therapeutic effect of warming yang and excerting water in the treatment of malignant abdominal effusion.Methods:A comprehensive search of PubMed,Embase,Cochrane Library,CNKI,VIP Database,Wanfang Database and China Biomedical Database from the creating of the databases to December 1,2021 was conducted and the literature screening and data extraction were conducted independently by two researchers according to inclusion and exclusion criteria,and a meta-analysis was performed by using Review Manager 5.4 software.Results:A total of 16 randomized controlled trials were included,with a total of 1180 patients.The meta-analysis showed that the yang-warming and water-excerting method in the treatment of malignant abdominal effusion could improve the effective rate of treatment(RR=1.42;95%CI:1.31,1.54;P=0.00001),improve KPS score(MD=8.50;95%CI:7.22,9.78;P<0.00001),improve immune function(CD3^(+)T lymphocyte MD=6.37;95%CI:5.35,7.38;P<0.00001;CD4^(+)T lymphocyte MD=9.54;95%CI:8.51,10.57;P<0.00001;CD8^(+)T lymphocyte MD=-3.78,95%CI:-4.65,-2.91,P<0.00001;CD4^(+)/CD8^(+)T lymphocyte MD=0.64,95%CI:0.52,0.75,P<0.00001),decrease the amount of abdominal fluid accumulation(MD=-128.80;95%CI:-147.97,-109.62;P<0.00001),and raise the survival rate(1-year survival rate RR=1.34,95%CI:1.15,1.55,P=0.00001;3-year survival rate RR=1.90,95%CI:1.33,2.70,P=0.0004).In terms of safety,the yang-warming and water-excerting method could reduce adverse events of digestive tract reaction(P=0.01),bone marrow suppression(P=0.003)and abnormal liver and kidney function(P=0.02).Conclusion:The treatment of malignant abdominal effusion by the yang-warming and water-excerting method can improve the clinical effective rate and survival rate in the treatment of malignant abdominal effusion and improve KPS score and immune function,and has good safety.

关 键 词：恶性腹腔积液 META分析 温阳利水 

分 类 号：R730.5[医药卫生—肿瘤]