12种中药注射剂联合吉西他滨和顺铂化疗方案治疗非小细胞肺癌的网状Meta分析

Network Meta-analysis of 12 Chinese Herb Injections Combined with Gemcitabine and Cisplatin for Non-small Cell Lung Cancer

目的:采用网状Meta分析评价12种中药注射剂联合吉西他滨和顺铂(GP)治疗非小细胞肺癌(NSCLC)的价值。方法:检索Science Citation Index Expanded(SCI-EXPANDED)、EMBASE、Pub Med、Cochrane Library、Cancer Lit、中国学术期刊网络出版总库(CNKI)、维普中文科技期刊全文数据库(VIP-CSJFD)、中国生物医学文献数据库(CBM)、万方数据期刊论文资源(WANFANG)、中国科学引文数据库(CSCD)和中国中医药等数据库,同时检索在研研究和相关学术组织网站,补充其他检索获取中药注射剂联合GP治疗NSCLC的随机对照试验(RCTs),按预先制定的纳入与排除标准筛选和纳入,并对纳入RCTs的质量进行质量评价,数据采用Win Bugs软件进行数据分析。结果:共纳入12种中药注射剂,61个RCTs,共4480例患者。纳入RCTs的质量并不高,网状Meta分析结果显示:以GP化疗方案为共同干预措施,复方苦参注射液+GP和艾迪注射液+GP分别与得力生注射液+GP在有效率方面和康莱特注射液+GP在恶心呕吐发生率方面的差异有统计学意义,而其他注射液+GP之间的差异无统计学意义;在生活质量和白细胞减少方面,12种中药注射剂之间的差异无统计学意义。结论:基于网状Meta分析和测量指标排序核密度结果,蟾酥注射液、消癌平注射液和康艾注射液较其他9种中药注射剂相对有效。

Objective： To assess the clinical effects and safety of Chinese herb injection （CHI） combined gemcitabine and cisplatin （GP） for non-small cell lung cancer（NSCLC）. Methods： The relative randomized controlled trials （RCTs） of CHIs were searched from Science Citation Index Expanded （SCI-EXPANDED） , PubMed, EMBASE, Cochrane Library, CancerLit, Chinese Knowledge Infrastruc- ture（ CNKI）, Chinese Scientific Journals Fulltext Database （VIP-CSJFD）, Chinese Biomedical Literature Database （CBM）, Wan-Fang Database （WANFANG）, Chinese Science Citation Database（CSCD） and Traditional Chinese Medical Database System. The related refer- ences and website were also traced. The RCTs were screened according to the predefined inclusion and exclusion criteria, the related items were used to assess the quality of RCTs, data were analyzed by WinBugs software. Results： 61 RCTs including 4480 patients and 12 CHIs were finally included. The quality of included RCTs were not high. The results of network Meta-analyses showed that, combined with GP, there were significant difference between compound matrine injection and ranglaite injection in efficacy, aidi injection and ranglaite injec- tion in efficacy, compound matrine injection and kanglaite injection in nausea and vomiting, aidi injection and kanglaite injection in nau- sea and vomiting, but no difference between other CHIs in efficacy and nausea and vomiting. At the same time, there were no difference between 12 CHIs in quality of life and leukopenia. Conclusion： Based on the results of network Meta-analysis and rank, chansu injection, xiaohiping injection and kangai injection were more than other 9 CHIs.