补肾中药联合双膦酸盐治疗恶性肿瘤骨转移有效性及安全性的Meta分析  

Efficacy and safety of kidney-tonifying Chinese medicine combined with bisphosphonates for treating bone metastases of malignant tumors:a meta-analysis

作　　者：冯媛媛[1] 赖优莹[1] 刘宁宁[1] 刘宏杰[1] 贾茹 朱惠蓉[1] 毛旻航 王炎[1] Feng Yuanyuan;Lai Youying;Liu Ningning;Liu Hongjie;Jia Ru;Zhu Huirong;Mao Minhang;Wang Yan(Departmentof Oncology,Shuguang Hospital Affiliatedto Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Departmentof Nuclear Medicine,Shuguang Hospital Affiliatedto Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属曙光医院肿瘤科,上海201203 [2]上海中医药大学附属曙光医院核医学科,上海201203

出　　处：《保健医学研究与实践》2024年第3期55-62,共8页Health Medicine Research and Practice

基　　金：国家自然科学基金(82122075、82074232、82030118、81830120);上海市炎症性疾病与证候生物学前沿研究基地肿瘤转化项目(2021KJ03-12);上海市教委、上海市教育发展基金会“曙光”项目(21SG43);上海市中医药三年计划项目[ZY(2021-2023)-0208];上海市青年人才支持计划项目。

摘　　要：目的系统评价补肾中药联合双膦酸盐类药物治疗恶性肿瘤骨转移的有效性及安全性,以期为临床治疗提供参考。方法通过检索CNKI、CBM、VIP、Wanfang Data等数据库,检索时间为所有数据库建库至2023年5月5日,筛选补肾中药联合双膦酸盐类药物治疗恶性肿瘤骨转移的随机对照临床试验,使用Cochrane偏倚风险评估工具对纳入的文献质量进行评估,并采用Rev Man 5.3软件对纳入研究进行Meta分析。结果共纳入18项临床研究,总样本量为1213例,其中对照组594例,治疗组619例。治疗组患者骨转移无进展生存时间、骨转移病灶疗效、止痛效果、数字化评估量表(NRS)疼痛评分、Karnofsky功能状态评估表(KPS)评分、活动能力、血钙水平及不良反应发生情况均优于对照组,差异均有统计学意义(P<0.05)。2组患者治疗前后碱性磷酸酶水平差异无统计学意义(P>0.05)。结论补肾中药联合双膦酸盐类药物可以抑制骨转移病灶进展,减轻骨转移引起的疼痛,改善患者生活质量及活动能力,并且可以降低血钙水平及不良反应发生率,证明从肾论治恶性肿瘤骨转移有一定的临床意义。Objective This study systematically evaluates the efficacy and safety of kidney-tonifying Chinese medicine com-bined with bisphosphonates in treating bone metastases of malignant tumors,aiming to provide evidence for clinical treat-ment.Methods Databases including CNKI,CBM,VIP,and Wanfang Data were searched for randomized controlled trials(RCTs)involving kidney-tonifying Chinese medicine combined with bisphosphonates for treating bone metastases up to May 5,2023.The quality of included studies was assessed using the Cochrane risk of bias tool,and Meta-analysis was performed using RevMan 5.3 software.Results Eighteen clinical studies were included,with a total sample size of 1213 cases,594 in the control group and 619 in the treatment group.The treatment group showed significant improvements in progression-free survival for bone metastases,treatment efficacy for bone lesions,pain relief,NRS pain scores,KPS scores,activity levels,blood calcium levels,and adverse event rates compared to the control group(P<0.05).No significant difference was ob-served in alkaline phosphatase levels between the two groups before and after treatment(P>0.05).Conclusion Kidney-tonifying Chinese medicine combined with bisphosphonates can inhibit the progression of bone metastases,reduce pain caused by bone metastases,increase quality of life and activity levels,and reduce blood calcium levels and adverse event rates.This demonstrates a clinical significance in treating bone metastases of malignant tumors from a kidney-tonifying per-spective.

关 键 词：补肾中药 恶性肿瘤骨转移 安全性 

分 类 号：R739.9[医药卫生—肿瘤]