头颈部肿瘤患者放疗引起的唾液腺功能减退症和口干症治疗的Meta分析

A Meta-analysis of radiotherapy-induced salivary hypofuction and xerostomia in patients with head and neck cancer

目的:本研究系统地评价分析对于头颈部肿瘤患者放疗引起的唾液腺功能减退症以及口干症采取的各种干预措施的临床有效性。方法:计算机检索Cochrane Library、Pubmed、EMBASE、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,检索时间从各数据库建库至2014年2月;同时辅助其它检索,纳入头颈部癌患者放疗引起的唾液腺功能减退症和口干症治疗的随机对照试验。两名评价者独立评价纳入研究的质量并提取资料,并用Rev Man 5.2.7软件进行统计分析。结果:共纳入8篇随机对照试验,包括毛果芸香碱,针灸以及唾液替代品等干预措施。Meta分析结果显示:与安慰剂相比,毛果芸香碱治疗组具有一定的治疗效果(主观量表测量以及客观测量)。与此同时,当前数据显示,与安慰剂比较,针灸治疗以及唾液替代品治疗在放疗治疗相关性的唾液腺功能减退症以及口干症方面没有统计学差异。结论:当前证据显示,毛果芸香碱治疗放疗引起的唾液腺功能减退症以及口干症有优势,该结果可能会受到样本量的限制且仅供临床参考。

Objective： The aim of this study is to evaluate the clinical efficacy of various treatment options for patients with head and neck cancer. Methods：We searched relevant randomized controlled trials （RCT） from Cochrane library, Pubmed, EMBASE, CBM, CQVIP, CNKI etc. The search was finished in February, 2014. We traced the related references and experts in this field, besides we also communicated with other authors to obtain some certain information that has not been found. RCTs of of radiotherapy-induced salivary hypofuction and xerostomia in patients with head and neck cancer were included. We evaluated the quality of these included studies and analyzed data by Cochrane Collaboration＆#39;s RevMan 5.2.7software. Results：Ultimately Eight RCTs were included. Current pooling results suggested that compared with the placebo-controlled, pilcarpine had merits in improving effects of patients with radiotherapy-induced salivary hypofuction and xerostomia. However, there was no significant difference between both acupuncture and salivary subsitute and its own placebo-controlled. Conclusions：Current data showed that pilcarpine had advantages in improving effects of patients with radiotherapy-induced salivary hypofuction and xerostomia, which might be limited by small sample and only worthy of reference.