甘露聚糖肽联合顺铂治疗恶性胸腔积液的系统评价

Systematic Review of Mannatide plus Cisplatin Treating Malignant Pleural Effusion

目的采用循证医学的方法评价甘露聚糖肽联合顺铂对比单用顺铂治疗恶性胸腔积液的有效性和安全性。方法计算机检索中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊全文数据库、万方数据库,收集甘露聚糖肽联合顺铂对比单用顺铂治疗恶性胸腔积液的随机对照试验,检索时间为各数据库建库至2011年3月。对文献进行质量评价,用RevMan 5.0软件对数据进行Meta分析。结果共纳入6项研究,所有文献质量均为C级。共收入388例患者,Meta分析结果显示甘露聚糖肽联合顺铂组与单用顺铂组相比,总有效率前者高于后者,差异有统计学意义(P<0.05);消化道不良反应发生率两组组间差异无统计学意义(P=0.05);骨髓抑制发生率前者低于后者,差异有统计学意义(P<0.05);Karnofsky评分提高率前者高于后者,差异有统计学意义(P<0.05)。结论系统评价表明,甘露聚糖肽联合顺铂治疗恶性胸腔积液的疗效优于单用顺铂的方案。

Objective To assess the clinical efficacy and safety of mannatide plus cisplatin treating malignant pleural effusion.Methods Literatures were retrieved from CBM,VIP,CNKI,Wanfang databases by computer.Literatures were enrolled according to inclusion and exclusion criteria,and the quality of studies was evaluated according to the Cochrane Library handbook.The period duration of searching was between the establishment of the databases and March,2011.Meta-analysis was conducted by RevMan 5.0 software.Results The meta-analysis of 6 included RCT,all ranked C,which involved 388 patients.The Meta-analysis showed that the total effective rate in mannatide plus cisplatin group significantly differed from that in cisplatin group（P0.05）.There were no significant difference in the adverse reaction of digestive tract between the two intervention groups（P=0.05）.The adverse reaction of marrow depression inmannatide plus cisplatin group was much lower than that in cisplatin group（P0.05）.The increase of KPS in mannatide plus cisplatin group was higher than that in cisplatin group（P0.05）.Conclusions The analysis indicates mannatide plus cisplatin has a better effect on malignant pleural effusion than single cisplatin.However,the reliability of this review is affected by poor quality of included studies,and large-scale randomized controlled trials of high quality are needed to confirm the conclusions above.