摘要
目的:系统评价香菇多糖注射液联合化疗治疗非小细胞肺癌(NSCLC)的临床疗效与安全性,以为临床提供循证参考。方法:计算机检索PubMed、EMBase、Cochrane图书馆、中国生物医学文献数据库、中文科技期刊全文数据库、万方数字化期刊全文数据库、中国期刊全文数据库,对收集到的香菇多糖注射液联合化疗治疗NSCLC的随机对照试验(RCT)进行方法学质量评价,并应用Rev Man 5.0统计软件进行Meta分析。结果:共纳入12项RCT,合计891例患者。Meta分析结果显示,香菇多糖注射液与吉西他滨+铂类(GP方案)、紫杉醇+铂类(TP方案)联用的总有效率[RR=1.39,95%CI(1.13,1.73),P=0.002;RR=1.39,95%CI(1.03,1.88),P=0.03]、生存质量改善率[RR=1.91,95%CI(1.49,2.45),P<0.000;RR=1.98,95%CI(1.33,2.94),P<0.000]、中重度胃肠道反应发生率[RR=0.55,95%CI(0.43,0.71),P<0.000;RR=0.40,95%CI(0.18,0.87),P=0.02]、中重度白细胞减少发生率[RR=0.69,95%CI(0.54,0.88),P=0.003;RR=0.44,95%CI(0.25,0.78),P=0.005]等均显著优于对照组。而香菇多糖注射液与长春瑞滨+铂类(NP方案)联用除了可以提高患者生存质量改善率[RR=1.79,95%CI(1.31,2.45),P<0.000]外,其余各项与对照组比较差异均无统计学意义。结论:香菇多糖注射液联合化疗治疗NSCLC,能提高近期疗效、降低毒副作用,但远期疗效有待进一步证实。
BJECTIVE： To evalute the clinical efficacy and safety of Lentinan injection combined with chemotherapy in the treatment of non-small cell lung cancer （NSCLC）, and to provide evidence-based reference for clinical use. METHODS： Retrieved from PubMed, EMBase, Cochrane, CBM, VIP, Wanfang database and CNKI, RCTs about Lentinan injection combined with chemotherapy in the treatment of NSCLC were collected. The methodology quality evaluation of RCTs was evaluated, and Meta-analysis was conducted by using Rev Man 5.0 statistical software. RESULTS： A total of 12 RCTs were included, involving 891 patients. Meta-analysis indicated that total effective rate [RR = 1.39,95 % CI （ 1.13, 1.73 ）, P= 0.002 ; RR= 1.39,95 % CI （ 1.03,1.88 ）, P= 0.03], improvement rate of quality life [RR= 1.91,95%CI（1.49,2.45） ,P〈0.000; RR= 1.98,95%CI（1.33,2.94） ,P〈0.000], the incidence of medium and severe gastrointestinal reaction [RR=0.55,95%CI（0.43,0.71）,P〈0.000];RR=0.40,95%CI（0.18,0.87）,P=0.02], the incidence of medium and severe leucopenia [RR^0.69, 95% CI （0.54, 0.88）, P=0.003 ; RR=-0.44, 95% CI （0.25, 0.78）, P= 0.005] of Lentinan injection combined with gemcitabine＋platinum （GP scheme） or taxinol＋platinum （TP scheme） were better than those of control group. Lentinan injection combined with NP scheme was better than control group of improvement rate of quality life [RR= 1.79, 95 % CI （ 1.31,2.45）, P〈 0.000], but there was no statistical significance in other indications. CONCLUSIONS ： Len- tinan injection combined with chemotherapy in the treatment of NSCLC can improve short-term efficacy and reduce toxic effect, and long-term efficacy is to be proven.
出处
《中国药房》
CAS
CSCD
2014年第32期3033-3037,共5页
China Pharmacy
