基于Meta分析的鸦胆子油乳注射液联合化疗治疗肝癌临床评价研究

Meta-analysis of Javanica Oil Emulsion Injection Plus Transcatheter Hepatic Arterial Chemoembolizationin Treatment with Liver Carcinoma

目的:评价鸦胆子油乳注射液联合肝动脉栓塞化疗治疗肝癌的临床疗效及安全性。方法:计算机检索the Cochrane Library,Pub Med、EMBASE、Sino Med、中国知网、维普期刊数据库和万方数据库,全面搜集鸦胆子油乳注射液联合肝动脉栓塞化疗治疗肝癌的随机对照试验,对纳入文献进行质量评价,提取资料并通过RevMan 5.3软件进行数据分析。结果:共纳入14篇文献,累计1 084例受试者。Meta分析结果显示:在肝动脉栓塞化疗基础上联用鸦胆子油乳注射液治疗肝癌可以提高临床疗效(RR=1.42,95%CI:1.20 1.69,P<0.000 1),改善生存质量(RR=1.68,95%CI:1.27 2.23,P=0.000 3)。此外,鸦胆子油乳注射液还可改善化疗引起的不良反应,但不能提高肝癌患者生存率。结论:鸦胆子油乳注射液联合肝动脉栓塞化疗在治疗肝癌方面具有较好的疗效,但本研究结论还需要进一步大样本严格的随机对照试验来证实。

Objective： To assess the clinical effectiveness and safety of Javanica oil emulsion injection combined with transcatheter hepatic arterial chemoembolization（TACE） in the treatment of liver carcinoma. Methods： A thorough and systematic retrieval of randomized controlled trials（RCTs） which regarding Javanica oil emulsion injection combined with TACE for treating liver carcinoma was conducted by using literature databases. The methodological quality of the included RCTs was evaluated,and then the data were extracted and Meta-analysed by Rev Man 5. 3 software. Results： A total of 14 RCTs with 1 084 participants were included. In the Meta-analysis,Javanica oil emulsion injection plus TACE can be better than TACE in the treatment of liver carcinoma in respect of total effective rate（RR=1. 42,95% CI： 1. 20-1. 69,P〈0. 000 1）,and improvement of life quality（RR=1. 68,95% CI： 1. 27-2. 23,P=0. 000 3）. In addition,Javanica oil emulsion injection can reduce adverse reactions; however,Javanica oil emulsion injection could not increase survival of liver carcinoma patients. Conclusion： Javanica oil emulsion injection plus TACE can be beneficial in the treatment of liver carcinoma. While our study still needs to be proved by more rigorously designed randomized controlled trials（RCT）.