中药汤剂治疗蒽环类药物所致心脏毒性的网状Meta分析

Network Meta-analysis of Cardiotoxicity Caused by Chinese Herbal Decoction for the Treatment of Anthracyclines

目的系统评价中药汤剂在伴有蒽环类药物的治疗效果下对心脏毒性的防治效果。方法计算机检索PubMed、ELSEVIER、The Cochrane Library、Web of Science、CNKI和WanFang Date等数据库查找中药汤剂治疗蒽环类药物所致心脏毒性的对照案例数据并核对文献共纳入文献28篇,对照措施为西药对照或空白对照。采集文献中的数据利用Stata、Winbugs、R软件进行Meta分析。文献中的数据信息统一单位,由2位研究员经过筛选后除去数据不太清楚的文献和使用中药注射液,中成药的文献。结果Meta分析结果显示在LVEF方面,红景天汤剂具有最佳疗效。在CK-MB方面,当归养心汤具有最佳疗效。在CTNI方面,炙甘草汤最优。在心电图方面,益气养心汤最优。结论综合各个指标的结果,生脉汤剂,益气养心汤,参芪仙补汤,红景天汤剂是较优疗效的中药汤剂,在对肿瘤蒽环类化疗导致心脏毒性方面具有保护作用并减轻心脏损伤。

Objective To ssystematically evaluate Chinese herbal decoction on the prevention and treatment effect of cardiac toxicity under the therapeutic regime of anthracycline drugs. Methods We conducted computer retrieval of databases such as PubMed, ELSEVIER, The Cochrane Library, Web of Science, CNKI and WanFang to find controlled cases data on treating cardiotoxicity caused by anthracyclines with Chinese medicine decoction. A total of 28 literatures were included after checking and filtering. Among them, the controlled measures were Western medicine or blank controlled. The data in the collection literatures was Meta-analyzed by applying Stata, Winbugs and R software. It had unified units, then 2 researchers screened to remove the literatures of unclear data and the literatures which their treatment includes Chinese medicine injections, Chinese patent medicine.Results Meta-analysis results showed that the Hongjingtian decoction had the best effect on LVEF. In CK-MB, Danggui Yangxin decoction had the best effect. In CTNI, Zhigancao decoction was the best. In ECG, the best was Yiqi Yangxin decoction.Conclusion Comprehensive results of various indicators, Shengmai decoction, Yiqi Yangxin decoction, Shenqi Xianbu decoction and Hongjingtian decoction have a better efficacy in the tumor chemotherapy of anthracycline which lead to cardiac toxicity and have protective effect while reducing heart damage.