补肾法治疗骨转移癌疗效及安全性的Meta分析

Meta analysis on the efficacy and safety of bone metastases treated with the kidney tonification therapy

目的系统评价中医补肾法联合双磷酸盐治疗骨转移癌的临床疗效以及安全性。方法计算机检索CBM、CNKI、VIP和万方等数据库,检索所有中医补肾法联合双磷酸盐治疗骨转移癌的随机对照试验(RCTs),并采用Revan 5.3软件对纳入研究的参考文献进行Meta分析。结果与单纯使用双磷酸盐相比,中医补肾法联合双磷酸盐可有效提高骨转移癌灶骨质修复疗效[OR=2.95,95%CI(1.69,5.13),P=0.002]及止痛疗效[OR=3.74,95%CI(2.45,5.71),P<0.000 01]。不良事件方面,两组差异均无统计学意义(P=0.150)。结论中医补肾法联合双磷酸盐治疗骨转移癌能有效提高骨转移癌灶骨质修复疗效和止痛疗效,对治疗骨转移癌的临床用药具有一定参考性,但鉴于本研究纳入RCTs数量和质量有限,未来需要更严格的、大样本的随机双盲试验对中医补肾法联合双磷酸盐治疗骨转移癌的临床疗效以及安全性进行验证。

Objective To review systematically the clinical efficacy and safety on bone metastasis treated with TCM kidney tonification therapy and diphosphonate. Methods All of the randomized controlled trials（RCTs） on bone metastasis treated with TCM kidney tonification therapy and diphosphonate were retrieved from CBM,CNKI,VIP and Wanfang databases. Revan 5. 3 software was adopted for the Meta analysis of the included RCTs. Results The sclerotic repair efficacy in the foci of bone metastases[OR = 2. 95,95% Cl（1. 69,5. 13）,P = 0. 002]and the pain-relief efficacy[OR =3. 74,95% Cl（2. 45,5. 71）,P〈0.000 01]were effectively improved with the treatment of the combined therapy of TCM kidney tonification and the medication of diphosphonate,as compared with the simple medication of diphosphonate. The differences in the adverse events were not significant between the two groups（P = 0. 15）. A total of 9 literatures were included in Meta analysis. It is viewed that the combined therapy of TCM kidney tonification and the medication of diphosphonate effectively improves the sclerotic repair efficacy in the foci of bone metastases and the pain-relief efficacy. Regarding the adverse events,there is no significant difference between the two groups. Conclusion The results provide the references to the clinical medication for bone metastases. But,because of the limited numbers and quality of the included RCTs,it is required the more rigorous and large-sample RCTs to verify the clinical efficacy and safety of the combined treatment with TCM kidney tonification and diphosphonate for bone metastases.