复方阿胶浆防治癌症化疗后骨髓抑制疗效和安全性的系统评价

Efficacy and safety of compound Ejiao Jiang for bone marrow suppression after cancer chemotherapy:A systematic review

[目的]系统评价复方阿胶浆联合化疗防治癌症化疗后骨髓抑制的有效性和安全性。[方法]计算机检索CNKI、WanFang、SinoMed、PubMed、EMbase、The Cochrane Library,搜集关于复方阿胶浆联合常规化疗治疗癌症/肿瘤患者的随机对照试验,检索时限从建库至2017年3月。由2位作者独立筛选文献、提取资料,采用RevMan 5.3软件进行Meta分析。[结果]共纳入17个RCT,包含7个结局指标,1 139例患者。Meta分析结果显示,与单纯化疗组相比,联用复方阿胶浆组在改善外周血象白细胞[MD=-0.71,95%CI (-1.14,-0.28),P=0.001;OR=0.24,95%CI(0.13,0.48),P<0.0001]、血红蛋白[MD=-10.34,95%CI(-15.10,-5.58),P<0.001;OR=0.28,95%CI(0.14,0.54),P=0.000 2]、血小板[MD=-20.94,95%CI(-35.63,-6.25),P=0.005]、红细胞[MD=-0.46,95%CI(-0.69,-0.23),P<0.000 1]及生活质量[OR=3.84,95%CI (2.07,7.11),P<0.000 1]方面差异有统计学意义;对降低血小板所致骨髓毒性[OR=0.58,95%CI(0.27,1.21),P=0.15]、保护中性粒细胞[MD=-0.10,95%CI(-0.66,0.47),P=0.73]及不良反应等方面差异均无统计学意义。[结论]当前证据提示复方阿胶浆联合化疗能够改善癌症化疗后外周血象和生活质量,且安全性较好。但由于纳入文献质量不高,尚需严格设计的高质量临床研究进一步验证。

[Objective] To systematically evaluate the efficacy and safety of combination of chemotherapy and compound Ejiao Jiang for bone marrow suppression after cancer chemotherapy.[Methods] We searched databases to collect RCTs of compound Ejiao Jiang combined with chemotherapy from inception to March 2017. Two researchers independently screened literature,extracted data and evaluated the risk of bias,and did Meta-analysis by RevMan 5.3.[Results] A total of 17 RCTs,involving 7 outcomes and 1 139 patients were included. The results of Meta-analysis showed that:compared with the chemotherapeutic group,compound Ejiao Jiang group had a higher count of white blood cell [MD=-0.71,95%CI(-1.14,-0.28),P=0.001;OR=0.24,95%CI(0.13,0.48),P<0.000 1],hemoglobin [MD=-10.34,95%CI(-15.10,-5.58),P<0.001;OR=0.28,95%CI(0.14,0.54) 0.000 2],blood platelet [MD=-20.94,95%CI(-35.63,- 6.25),P=0.005],red blood cell [MD=-0.46,95%CI (-0.69,-0.23),P<0.000 1](OR=3.88,95%CI (2.07,7.11),P<0.000 1] and life quality [OR=3.84,95%CI (2.07,7.11),P<0.000 1],with statistical significance;while had no statistical significance in lower count of bone marrow toxicity owing to blood platelet [OR=0.58,95%CI(0.27,1.21),P=0.15],neutrophils [MD=-0.10,95%CI(-0.66,0.47),P= 0.73] and adverse reactions.[Conclusions] The current evidence shows that chemotherapy compound Ejiao Jiang is better to improve the peripheral hemogram and life quality after chemotherapy and is safety. However,due to the limited quality of included researches, conclusions still need to be verified by high quality researches with better design.