参麦注射液联合化疗治疗乳腺癌疗效和毒副作用的Meta分析

Meta analysis of the efficacy and toxicity of Shenmai injection combined with chemotherapy in the treatment of breast cancer

目的系统评价参麦注射液联合化疗治疗乳腺癌的疗效和毒副作用。方法计算机检索PubMed、Embase、Web of Science、cochrane library、中国知网、万方数据,检索时限均为建库至2023年6月1日,纳入参麦注射液联合化疗治疗乳腺癌的随机对照试验。筛选文献、提取资料并对纳入文献质量进行评价后,采用ReMan 5.4软件进行Meta分析和发表偏倚分析。结果共纳入29项RCT,合计3039例患者。Meta分析结果显示,试验组的疗效、LVEF、SOD、GSH均明显高于对照组,试验组的不良反应、cTn、CK-MB、MDA均明显低于对照组。结论目前证据支持参麦注射液联合化疗治疗乳腺癌可在提高疗效的同时,降低化疗对患者造成的消化道反应、血液毒性、心脏毒性、氧化应激损伤等,促进T细胞亚群(CD3、CD4和CD8)恢复以提高患者的免疫力,但目前研究的样本量较小,证据级别较低,上述结论今后还需更多大样本、高质量的临床研究进一步验证。

Objective To systematically evaluate the efficacy and side effects of Shenmai injection combined with chemotherapy in the treatment of breast cancer.Methods Computerized searches were conducted in PubMed,Embase,Web of Science,cochrane library,CNKI(China National Knowledge Infrastructure),and Wanfang Data up to June 1,2023.Randomized controlled trials that assessed the use of Shenmai injection combined with chemotherapy for breast cancer were included.After literature screening,data extraction,and quality assessment of the included studies,a meta-analysis and publication bias analysis were performed using ReMan 5.4 software.Results A total of 29 RCTs were included,with a total of 3039 patients.The result of Meta analysis showed that the efficacy,LVEF,SOD,and GSH of the experimental group were significantly higher than those of the control group,and the adverse reactions,cTn,CK-MB,and MDA of the experimental group were significantly lower than those of the control group.Conclusion Currently,the evidence supports that the combination of Shenmai injection with chemotherapy in the treatment of breast cancer can not only improve efficacy but also reduce chemotherapy-induced gastrointestinal reactions,hematological toxicity,cardiac toxicity,oxidative stress damage,and promote the recovery of T-cell subsets(CD3,CD4,CD8)to enhance the patient's immune system.However,it should be noted that the sample size in the current research is relatively small,and the level of evidence is low.Therefore,the above conclusion will require further validation through larger sample sizes and higher-quality clinical studies in the future.