口服中药治疗恶性腹水随机对照试验的系统评价及Meta分析

Meta analysis of oral Chinese medicine for the treatment of malignant ascites of randomized controlled trials

目的系统评价口服中药在恶性腹水(MA)治疗中的疗效及对患者生存质量的改善作用。方法交叉检索各大电子数据库,检索年限到2014年9月,纳入符合标准的随机对照试验(RCT)。参照Cochrane系统评价的要求,对选择纳入的临床试验进行方法学质量的评估、数据的提取和数据的分析。结果纳入符合要求的RCT中文文献27篇,共纳入1 742例,观察组906例,对照组836例。17篇文献明确的记录有生活质量评分变化。1)27项随机对照研究的总有效率Meta分析结果显示RR 1.42;95%CI 1.32 to 1.53,P<0.001,差异有统计学意义,提示配合口服中药的观察组治疗恶性腹水疗效明显优于对照组。2)17篇文献进行生存质量的Meta分析结果显示RR 2.03;95%CI 1.72 to 2.39,P<0.001,差异有统计学意义,提示口服中药组的生存质量改善比对照组更显著。结论口服中药的参与能明显增加恶性腹水的有效控制率,改善患者的生存质量。

Objective The system evaluation of the therapeutic efficacy and effect on improving the quality of life of the patients who have Oral traditional Chinese medicine for the treatment of malignant ascites（ MA）. Methods Cross-retrieval major electronic databases,the search period to September 2014,Randomized controlled trials in line with the standard（ RCT）. Referring to Cochrane systematic review requirements,the choice of inclusion in clinical trials to assess the methodological quality,data extraction and analysis of data. Results 27 Chinese literature meeting the requirements were bring into,1742 patients were enrolled,including 906 in the observation group and 836 in the control group. 17 documents which have recorded a clear change in quality of life scores were analyzed. ①27 randomized controlled study of efficiency（ CR ＋ PR） Meta-analysis results（ RR 1. 42; 95% CI 1. 32 to 1. 53）,P〈0. 001,the difference was statistically significant,showing the observation group with oral medicine for treatment of malignant ascites was significantly better than the control group. ②17 articles were quality of life Meta- analysis results（ RR 2. 03; 95% CI 1. 72 to 2. 39）,P〈0. 001,the difference was statistically significant,the results show the quality of life of oral medicine group more significant improvement than the control group. Conclusion The controlment of malignant ascites and improve the quality of life of patients can be obviously improved,with the traditional Chinese medicine oral participation in treatment.