中医外治法防治奥沙利铂周围神经毒性的Meta分析

Meta-analysis on Efficacy of External Treatments of TCM for Oxaliplatin-induced Peripheral Neurotoxicity

目的:评价中医外治法防治奥沙利铂周围神经毒性疗效。方法:计算机检索Cochrane Library、美国国立医学图书馆(Pub Med)、中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)、维普中文科技期刊数据库(VIP)、万方数据库等数据库,检索中医外治法防治奥沙利铂周围神经毒性的随机对照试验,文种不限。结果:共纳入8个随机对照试验共有患者805例,Meta分析结果显示,与防寒保暖对照组比较,中医外治组能显著降低周围毒性发生率[OR=0.23,95%CI(0.16,0.31)],降低2级以上神经毒性发生率[OR=0.41,95%CI(0.32,0.51)]。结论:中医外治法能降低奥沙利铂周围神经毒性发生率,改善患者生活质量,但中药并不具有统一性,评价疗效尚存在一定难度,需要更多设计合理的高质量临床试验加以验证。

Objective： To assess the effects of external treatments of traditional Chinese medicine（ TCM） on Oxaliplatininduced peripheral neurotoxicity. Methods： By using literature search engines,the literature in Cochrane Library、Pub Med、CBM、CNKI、VIP and Wan fang with randomly designed studies with control on the effects of external treatments of TCM on Oxaliplatin-induced peripheral neurotoxicity. Results： All eight studies met the standard of selection. Compared with the control which just kept warming,the external treatments of TCM can reduce the rate of Oxaliplatin-induced peripheral neurotoxicity,and the odds ratio（ OR） of the treatments was 0. 23 [95% CI（ 0. 16,0. 31） ]. And they can reduce the rate of 2 grade or more,which the OR was 0. 41 [95% CI（ 0. 32,0. 51） ]. Conclusion： The external treatments of TCM can reduce the rate of Oxaliplatin-induced peripheral neurotoxicity,and can improve patient＇s quality of life,but the herbs do not have a unity. There are some difficulties for the evaluation of curative effect. We need more reasonable design,high quality clinical trial to test and verify.