复方苦参注射液联合化疗治疗淋巴瘤临床疗效与安全性的Meta分析

META-ANALYSIS OF CLINICAL EFFICACY AND SAFETY OF COMPOUND KUSHEN INJECTION FOR LYMPHOMA

目的系统评价复方苦参注射液联合化疗治疗淋巴瘤的临床疗效和安全性。方法计算机检索中国期刊全文数据库(CNKI)、万方数据库、维普期刊全文数据库(VIP)、中国生物医学文献数据库(CBM)等数据库,检索时间从各数据库建库至今,手工进行Googel学术搜索等对文献进行查漏补缺,收集复方苦参注射液联合化疗治疗淋巴瘤的随机对照实验,根据纳入和排除标准对所得文献进行筛选,对纳入的文献按Cochrane系统评价方法进行质量评价,应用Revman 5.0软件对提取的资料和数据进行Meta分析。结果共纳入7个随机对照试验,包括470例患者。总有效率:异质性检验P=0.76,相对危险度RR=1.33,95%CI(1.19,1.49),检验值Z=5.06,P<0.000 01,差异有统计学意义,表明复方苦参注射液联合化疗与单纯化疗相对,治疗淋巴瘤总有效率显著提高。Ⅲ+Ⅳ级不良反应结果显示,白细胞减少发生率:异质性检验P=0.95,相对危险度RR=0.28,95%CI(0.14,0.56),检验值Z=3.56,P=0.000 4<0.01,差异有统计学意义,表明复方苦参注射液联合化疗与单纯化疗相对,白细胞减少发生率显著降低;血小板减少发生率:异质性检验P=0.59,相对危险度RR=0.41,95%CI(0.22,0.75),检验值Z=2.91,P=0.004<0.01,差异有统计学意义,表明复方苦参注射液联合化疗与单纯化疗相对,血小板减少发生率也显著降低。结论复方苦参注射液联合化疗与单纯化疗方案相比,总体上能增加淋巴瘤患者治疗的有效率,同时减轻化疗相关不良反应。

Objective To evaluate the clinical efficacy and safety of compound Kushen injection for lymphoma. Method Retrieved from Chinese Academic Journal （ CNKI）, WanFang DATA, VIP CJFD （VIP）, Chinese Biomedical Literature Database （CBM） and other database from the time that each database was built, besides the literatures searched manually from google academic, etc. RCTs on compound Kushen injection combined with chemotherapy for lymphoma were collected and quality evaluation was carried out. Result A total of seven randomized controlled trials, including 470 cases of patients. Total efficiency ： test for heterogeneity （ P = 0. 76 ） , relative risk RR = 1.33,95% CI （ 1.19, 1.49）. Examining the value （Z =5.06） , P 〈0. 000 01. The difference was statistically significant, indicating that Compound Sophora Injection combination chemotherapy with chemotherapy alone. Opposed to treatment of lymphoma, it have significantly improved overall efficiency. Ⅲ ＋ Ⅳ grade adverse results showed that the incidence of neutropenia： the test for heterogeneity （P = 0. 95 ）, relative risk RR = 0. 28,95% CI（0. 14, 0. 56）. Examining the value （Z = 3.56）, P = 0. 000 4 〈 0.01. The difference was statistically significant, indicating that the compound matrine injection combined with chemotherapy versus chemotherapy alone contrast. The incidence of neutropenia was significantly reduced ; The incidence of thrombocytopenia ： test for heterogeneity （ P = 0. 59 ）, relative risk RR =0. 41,95% CI（0. 22, 0. 75）. Examining the value （Z =2. 91 ）, P =0. 004 〈0. 01. The difference was statistically significant, indicating that the compound matrine injection combined with chemotherapy versus chemotherapy alone contrast. The incidence of thrombocytopenia was significantly reduced. Conclusion Compared with chemotherapy, compound Kushen injection combined with chemotherapy for lymphoma could improve the total effective rate of Lymphoma and decrease the incidence of chemotherapy - related adverse reactions.