| 132 | 2 | 48 |
| 下载次数 | 被引频次 | 阅读次数 |
目的系统评价复方苦参注射剂用于辅助治疗中晚期肺癌的疗效及安全性,为临床提供循证参考。方法计算机检索Pub Med、Embase、Cochrane图书馆、中国知网、中国生物医学文献数据库、万方数字化期刊全文库、维普数据库、Clinical Trials数据库,检索其建库到2017年1月发表的复方苦参注射剂联合放化疗用于治疗晚期肺癌的随机对照试验(RCT),对其进行质量评估,对符合要求的所有文献研究结果进行Meta分析。结果最终纳入29项随机对照研究,合计2 726例患者。Meta分析结果显示:治疗组治疗有效率、临床受益率、Kamofsky评分改善率显著高于对照组(P<0.01),肝肾功能损害、便秘、严重骨髓抑制、严重消化道反应发生率显著低于对照组(P<0.01)。结论复方苦参注射剂联合放化疗治疗肺癌疗效优于单纯放化疗,可提高患者生存质量,降低放化疗引起的不良反应。
Abstract：AIM To systematically review the efficacy and safety of compound sophora injection( CSI) used in adjuvant therapy of advanced lung cancer,and provide evidence-based reference for clinic. METHODS The databases of Pub Med,Embase,Cochrane Library,CNKI,CBM,Wanfang,VIP and Clinical Trials were retrieved from databases establish time to Januany 2017,and randomized controlled trials( RCTs) about CSI combined with radiotherapy or chemotherapy in the treatment of advanced lung cancer were collected. Quality assessment was conducted and eligible results were included in Meta analysis. RESULTS Totally 29 RCTs were included,involving2 726 patients. Results of Meta analysis showed that the effective rate,clinical benefit rate and improvement rate of Kamofsky scores in test group were significantly higher than control group( P < 0. 01). The incidence of hepatorenal damage,constipation,severe bone marrow suppression and severe gastrointestinal reaction were significantly lower than control group( P < 0. 01),with statistical significances. CONCLUSION CSI combined with radiotherapy or chemotherapy is superior to conventional radiotherapy or chemotherapy alone in the treatment of lung cancer,which can improve life quality in patients and reduce the adverse reactions induced by chemo thearpy.
[1]方伟岗,曹世龙.肿瘤学新理论与新技术[M].上海:上海科技技教育出版社,1997:1020-1030.
[2]陆新岸.复方苦参注射液联合同步放化疗治疗局部晚期非小细胞肺癌30例[J].河北中医,2010,32(10):1542.
[3]江雨顺,杨杰.周剂量顺铂胸腔灌注联合复方苦参注射液治疗非小细胞肺癌并恶性胸腔积液的临床研究[J].现代医药卫生,2013,29(11):1619.
[4]杨波.中西医结合治疗晚期非小细胞肺癌疗效分析[J].亚太传统医药.2014,10(15):83.
[5]张敬伟,段冬梅,任中海.苦参注射液联合GP方案对非小细胞肺癌的影响[J].中国实验方剂学杂志,2015,21(23):184.
[6]代艳玲,李红梅.复方苦参注射液治疗肺癌化疗后癌因性疲乏的疗效[J].临床用药,2013,13(8):722.
[7]杨青山,姜丽朋.复方苦参注射液预防放射性肺损伤的疗效观察[J].中国药房,2011,22(4):360.
[8]韩慧芳,郭娟.复方苦参注射液联合培美曲塞和顺铂一线治疗晚期肺腺癌的临床观察[J].中国医院用药评价与分析,2012,12(12):1115.
[9]王乐园,潘颖萍.复方苦参注射液联合化疗治疗晚期非小细胞肺癌疗效分析[J].辽宁中医杂志,2009,36(12):2098.
[10]吴德林,陈猛.复方苦参注射液联合化疗晚期非小细胞肺癌疗效分析[J].中国保健营养,2014,03(下):1223.
[11]方红明,蒋国军.复方苦参注射液联合多西他赛每周方案治疗老年晚期非小细胞肺癌33例临床观察[J].中医杂志,2012,53(9):764.
[12]冯原,吉非替尼联合复方苦参注射液治疗非小细胞肺癌临床研究[J].中医学报,2013,12(12):1779.
[13]章娟娟,杨军礼.复方苦参注射液治疗晚期非小细胞肺癌临床观察[J].新中医,2015,47(1):190.
[14]王怡冰.复方苦参注射液联合化疗治疗晚期非小细胞肺癌临床研究[J].中医学报,2015,30(12):1710.
[15]王少锋,侯彩云.复方苦参注射液联合化疗治疗非小细胞肺癌骨转移疼痛的临床观察[J].现代肿瘤医学,2016,24(1):49.
[16]刘冉.复方苦参注射液联合放疗治疗肺癌50例临床观察[J].国医论坛,2015,30(5):36.
[17]桑新文.复方苦参注射液联合长春瑞滨+顺铂方案治疗非小细胞肺癌的临床观察[J].中国医院用药评价与分析,2012,12(7):645.
[18]赵凯,杨俊泉.复方苦参注射液联合GP方案治疗晚期非小细胞肺癌临床疗效及生存质量影响[J].实用预防医学,2012,19(12):1853.
[19]侯炜,刘杰.复方苦参注射液防治原发性肺癌放射性肺炎的多中心、随机对照临床研究[J].临床研究,2013,22(17):2065.
[20]张慧辉,张灵敏.复方苦参联合吉西他滨治疗晚期非小细胞肺癌疗效观察[J].陕西中医,2013,34(4):384.
[21]于振刚,王炳辙.大剂量复方苦参注射液联合化疗治疗晚期非小细胞肺癌疗效观察[J].中国医院用药评价与分析,2012,12(2):149.
[22]朱黎明,郭建峰.岩舒注射液治疗晚期非小细胞肺癌的临床研究[J].中国肿瘤临床与康复,2011,18(4):380.
[23]黄智芬,刘俊波,黎汉忠,等.复方苦参注射液结合化疗治疗中晚期非小细胞肺癌30例[C].ITAC2007国际中医药肿瘤学术大会,2007:319.
[24]陆红,周涛,佘文莉.苦参注射液联合紫杉醇同步调强放疗对局部晚期非小细胞肺癌患者生活质量的影响[J].暨南大学学报(医学版),2011,32(2):247.
[25]王菁,郭丹,王静怡,等.复方苦参注射液减轻放射性肺损伤和改善生活质量的临床研究[J].肿瘤研究与临床,2013,25(9):612.
[26]许淼,张丽萍.复方苦参注射液联合化疗治疗老年中晚期非小细胞肺癌的疗效观察[J].中国老年学杂志,2009,29(9):1161.
[27]张陪新,陈坤,王春雨.复方苦参注射液联合NP方案治疗中晚期非小细胞肺癌50例[C].CCAC中国肿瘤&名医学术大会,2008:156.
[28]张春梅.复方苦参注射液联合同步放化疗对局部晚期非小细胞肺癌的疗效观察[J].中国初级卫生保健,2016,30(5):66.
[29]冯广辉.复方苦参注射液联用吉西他滨治疗晚期非小细胞肺癌临床观察[J].中国农村卫生,2016,2(80):11.
[30]樊庆利.苦参注射液在非小细胞肺癌治疗中的应用效果及其对患者生存质量的影响分析[J].中国医药科学,2015,5(21):95.
[31]ZHAO B,LI B,BAI S,et al.Effects of matrine on proliferation and apoptosis of cultured retinoblastoma cells[J].Graefes Arch Clin Exp Ophthalmol,2012,250(6):897.
[32]卢前微,陈建斌,汤为学,等.苦参碱诱导U937细胞分化及其相关机制[J].第四军医大学学报,2009,30(18):1714.
[33]周喜汉,韦星,黄赞松,等.苦参碱对结肠癌SW1116细胞增殖及端粒酶活性的影响[J].中药材,2009,32(6):923.
[34]LIANG CZ,ZHANG JK,SHI ZL,et al.Matrine induces caspasedependent apoptosis in human osteosarcoma cells in vitro and in vivo through the upregulation of Bax and Fas/Fas L and downregulation of Bcl-2[J].Cancer Chemother Pharmacol,2012,69(2):317.
[35]ZHANG SH,ZHANG Y,ZHUANG Y,et al.Matrine induces apoptosis in human acute myeloid leukemia cells via the mitochondrial pathway and akt inactivation[J].PLo S O,2012,7(10):1.
[36]DAI ZJ,GAO J,JI ZZ,et al.Matrine induces apoptosis in gastric carcinoma cellsvia alteration of Fas/Fas L and activation of caspase-3[J].J Ethnopharmacol,2009,123(1):91.
[37]周炳刚,沈义军,杨涛,等.苦参碱诱导人乳腺癌细胞凋亡逆转耐药及对酸化蛋白激酶-B、Fas、半胱氨酰天冬氨酸特异性蛋白酶-3表达的影响[J].中华实验外科杂志,2012,29(9):1856.
[38]LUO SX,DENG WY,WANG XF,et al.Molecular mechanism of indirubin-3'-monoxime and Matrine in the reversal of paclitaxel resistance in NCI-H520/TAX25 cell line[J].Chinese Medical Journal,2013,126(5):925.
[39]黄琳,李彬,胡作为,等.复方苦参注射液联合化疗对大肠癌术后化疗患者免疫功能的影响[J].中国新药杂志,2011,20(6):526.
[40]王慧林,李清贤.复方苦参注射液对非小细胞肺癌化疗免疫功能影响[J].医药论坛杂志,2013,34(7):61.
基本信息:
中图分类号:R734.2
引用信息:
[1]郭一萌,杨静,严虹霞,等.复方苦参注射剂用于肺癌辅助治疗有效性和安全性的Meta分析[J].中国临床药学杂志,2017,26(06):388-394.
2017-11-25
2017-11-25