3种中药注射剂预防奥沙利铂所致周围神经毒性的网状Meta分析

Network Meta-analysis of efficacy of 3 kinds of Chinese medicine injections in preventing oxaliplatin-induced peripheral neurotoxicity in cancer patients

目的:采用网状Meta分析的方法比较中药注射剂(CMI)预防奥沙利铂所致周围神经毒性(OIPN)的疗效。方法:全面检索PubMed、EMbase、Cochrane Libraries、CNKI、万方和维普数据库中收录的CMI预防OIPN疗效的随机对照试验(RCT),检索时限均从建库至2015年11月。在资料提取和质量评价后,采用ADDIS1.16.6软件进行网状Meta分析。结果:共纳入13个RCT,包括926例患者,涉及3种CMI,分别为黄芪注射液(HQI)、参麦注射液(SMI)和参附注射液(SFI)。网状Meta分析显示:(1)3种CMI与对照组在OIPN总发生率及严重OIPN发生率方面均具有统计学差异,但3种CMI之间比较无统计学差异。(2)根据概率排序结果,预防OIPN总发生率的概率排序依次为HQI>SMI=SFI;预防严重OIPN发生率的概率排序依次为HQI>SMI>SFI。结论:3种CMI均能有效预防OIPN发生,降低OIPN发生率,其中HQI预防疗效最好。

OBJECTIVE To compare efficacy of Chinese medicine injections（CMI）in preventing oxaliplatin-induced peripheral neurotoxicity（OIPN）in cancer patients by applying network Meta-analysis.METHODS Studies were identified by searching PubMed,EMbase,Cochrane Libraries,CNKI,WanFang and WeiPu database from date of establishment until November 2015.Randomized controlled trials（RCT）that evaluated efficacy of CMI in preventing OIPN in cancer patients were included.Statistical analysis was performed with ADDIS 1.16.6.RESULTS Thirteen RCTs involving 926 patients were included.Three kinds of CMI were Huangqi injection（HQI）,Shenmai injection（SMI）and Shenfu injection（SFI）.The results of network Meta-analyses showed that,（1）there were statistically significant differences in incidences of OIPN and OIPN between 3 kinds of CMI and control group,but no statistically significant differences between 3 kinds of CMI;（2）probability ranking results showed efficacy in preventing incidence of OIPN was HQI〉SMI=SFI and efficacy in preventing incidence of severe OIPN was HQI〉SMI〉SFI.CONCLUSION Three kinds of CMI are effective neuroprotective agents against OIPN.Moreover,HQI is the most effective.