胸腔闭式引流术后注入榄香烯治疗恶性胸腔积液的疗效评价

Efficacy of elemene infusion following closed chest drainage as a treatment for malignant pleural effusion

目的：评价胸腔闭式引流术后胸膜腔内注入榄香烯治疗恶性胸腔积液的有效性.方法：检索MEDLINE（1996年1月至2010年10月）、中国生物医学文献数据库（1978年1月至2010年10月）、中国期刊全文数据库（1994年至2010年）、万方数据库（1980年至2010年）与重庆维普信息数据库（1989年至2010年）共5个数据库,同时从参考文献中追溯文献,并收集未发表的文献.纳入胸腔闭式引流术后,胸膜腔内注入榄香烯治疗恶性胸腔积液的随机对照试验,使用Cochrane中心推荐的方法进行文献质量评价,并用Rev Man 5.0软件进行统计分析.结果：共纳入17篇文献,16篇文献的方法学质量较低.其中12项独立研究对胸腔闭式引流术＋榄香烯与胸腔闭式引流术＋顺铂治疗的临床效果进行比较,合并分析结果显示榄香烯组的有效率高于顺铂组[RR合并=1.26,95%CI（1.13,1.39）].结论：胸膜腔闭式引流术后胸膜腔内注入榄香烯可以提高恶性胸腔积液治疗的有效率.

Objective：To evaluate the efficacy of elemene infusion following closed chest drainage as a treatment for for malignant pleural effusion. Methods： The articles of randomized controlled trials on elemene infusion after closed chest drainage for treatment of malignant pleural effusion from 5 databases including MEDLINE （Jan 1966-Oct 2010）,CBMdise （Jan 1978-Oct 2010）,CNKI （1994-2010）,Wanfang data （1980- 2010） and Chongqing VIP database （1989-2010） were retrieved. Literatures listed as references in these articles ,or unpublished papers, were obtained. The quality of these studies was evaluated based on criteria recommended by Cochrane Collaboration. A designated software, Rev Man 5.0, was used for statistical analysis. Results：Seventeen articles were included in the meta-analysis, 16 of which showed low quality in methodology. Among these, 12 independent studies compared the clinical effects of closed thoracic drainage combined with infusion of elemene vs eisplatin. Pooled analysis indicated that the effieicacy of elemene infusion was more favorable compared with cisplatin [ RR pooled = 1.26,95% CI （ 1.13,1.39 ） ]. Conclusion： Elemene infusion following closed chest drainage may be useful for a higher rate of improved outcomes in patients with malignant pleural effusion.