目的:探讨大剂量美法仑联合自体造血干细胞移植治疗多发性骨髓瘤的安全性、疗效和预后。方法:回顾2020年3月至2022年10月在皖南医学院弋矶山医院血液科进行自体移植一线巩固治疗的17例初诊多发性骨髓瘤患者的临床资料,分析治疗的安全性...目的:探讨大剂量美法仑联合自体造血干细胞移植治疗多发性骨髓瘤的安全性、疗效和预后。方法:回顾2020年3月至2022年10月在皖南医学院弋矶山医院血液科进行自体移植一线巩固治疗的17例初诊多发性骨髓瘤患者的临床资料,分析治疗的安全性、疗效和预后。结果:17例患者中,男性10例,女性7例,中位年龄56(45-64)岁。干细胞植入率100%,中性粒细胞中位植入时间为+10(9-12)d,血小板中位植入时间为+12(10-21)d。口腔黏膜炎及肠道感染发生率100%,肺部感染2例,泌尿系感染1例,皮肤感染1例;11例患者发生血清淀粉酶一过性升高。移植后评估13例获得CR以上疗效,CR率较移植前有提高趋势(13/17 vs 8/17;P=0.078)。中位随访18(6-36)个月,15例无进展存活,1例出现疾病进展,1例因临床复发放弃治疗而死亡,2年OS率约90.0%,2年PFS率约83.9%。结论:大剂量美法仑联合自体造血干细胞移植一线巩固治疗多发性骨髓瘤能加深患者缓解深度,进一步提高疗效,而且移植相关并发症可控,值得在临床中推广。展开更多
目的:系统评价口服中成药联合沙库巴曲缬沙坦治疗慢性心力衰竭(CHF)的临床疗效。方法:检索CNKI、CSPD、CCD、CBM、PubMed、Web of Science、Cochrane Library、EMbase,并通过手动筛选补漏文献,筛选口服中成药联合沙库巴曲缬沙坦治疗CHF...目的:系统评价口服中成药联合沙库巴曲缬沙坦治疗慢性心力衰竭(CHF)的临床疗效。方法:检索CNKI、CSPD、CCD、CBM、PubMed、Web of Science、Cochrane Library、EMbase,并通过手动筛选补漏文献,筛选口服中成药联合沙库巴曲缬沙坦治疗CHF的随机对照试验。采用Cochrane 5.1.0手册对纳入研究进行偏倚风险评估,利用RevMan 5.4软件进行Meta分析。结果:共纳入13项随机对照试验,包括1301名患者。Meta分析结果显示,口服中成药联合沙库巴曲缬沙坦治疗能进一步提高CHF患者的治疗后总有效率[RR=1.23,95%CI(1.16,1.30),P<0.001]、增加6 min步行距离[MD=53.04,95%CI(33.43,72.64),P<0.001]、提高射血分数[MD=6.67,95%CI(5.15,8.19),P<0.001]、提高每搏输出量[MD=7.56,95%CI(3.94,11.18),P<0.001]、减小左心室舒张末期内径[MD=-3.68,95%CI(-4.57,-2.78),P<0.001]、降低NT-proBNP[MD=-434.08,95%CI(-518.95,-349.22),P<0.001],与单纯沙库巴曲缬沙坦治疗,两组方案安全性差异无统计学意义[RR=0.73,95%CI(0.32,1.65),P=0.45]。结论:口服中成药联合沙库巴曲缬沙坦治疗CHF有较好的临床疗效,对临床实践有一定指导意义。展开更多
Objective:To systematically evaluate the clinical efficacy of oral Chinese patent medicine combined with sacubitril/valsartan in treating chronic heart failure(CHF).Methods:CNKI,CSPD,CCD,CBM,PubMed,Web of Science,Coch...Objective:To systematically evaluate the clinical efficacy of oral Chinese patent medicine combined with sacubitril/valsartan in treating chronic heart failure(CHF).Methods:CNKI,CSPD,CCD,CBM,PubMed,Web of Science,Cochrane Library and EMbase were retrieved to screen out randomized controlled trials Chinese patent medicine and Western medicine in treating CHF.Manual retrieval was also applied as a supplement.The Cochrane Reviewers Handbook 5.1.0 was used to evaluate the bias risk of the included studies and RevMan 5.4 software was used for Meta-analysis.Results:A total of 1301 patients enrolled in the 13 RCTs were included.According to the results of Meta-analysis,a combination of oral Chinese patent medicine and sacubitril/valsartan could further improve total effectiveness rate(RR=1.23,95%CI[1.16,1.30],P<0.001),increase 6 minutes’walk distance(MD=53.04,95%CI[33.43,72.64],P<0.001),improve left ventricular ejection fraction(MD=6.67,95%CI[5.15,8.19],P<0.001)and stroke volume(MD=7.56,95%CI[3.94,11.18],P<0.001),reduce left ventricular end-diastolic dimension(MD=-3.68,95%CI[-4.57,-2.78],P<0.001)and N terminal pro B type natriuretic peptide(MD=-434.08,95%CI[-518.95,-349.22],P<0.001)and no statistically significant difference in drug safety was found between the sacubitril/valsartan-only group and the combined treatment group(RR=0.73,95%CI[0.32,1.65],P=0.45).Conclusion:It’s indicated that a combination of traditional Chinese patent medicine and sacubitril/valsartan had a good clinical efficacy in the treatment of CHF,which had certain guiding significance for clinical practice.展开更多
文摘目的:探讨大剂量美法仑联合自体造血干细胞移植治疗多发性骨髓瘤的安全性、疗效和预后。方法:回顾2020年3月至2022年10月在皖南医学院弋矶山医院血液科进行自体移植一线巩固治疗的17例初诊多发性骨髓瘤患者的临床资料,分析治疗的安全性、疗效和预后。结果:17例患者中,男性10例,女性7例,中位年龄56(45-64)岁。干细胞植入率100%,中性粒细胞中位植入时间为+10(9-12)d,血小板中位植入时间为+12(10-21)d。口腔黏膜炎及肠道感染发生率100%,肺部感染2例,泌尿系感染1例,皮肤感染1例;11例患者发生血清淀粉酶一过性升高。移植后评估13例获得CR以上疗效,CR率较移植前有提高趋势(13/17 vs 8/17;P=0.078)。中位随访18(6-36)个月,15例无进展存活,1例出现疾病进展,1例因临床复发放弃治疗而死亡,2年OS率约90.0%,2年PFS率约83.9%。结论:大剂量美法仑联合自体造血干细胞移植一线巩固治疗多发性骨髓瘤能加深患者缓解深度,进一步提高疗效,而且移植相关并发症可控,值得在临床中推广。
基金National Natural Science Foundation of China (No.81803925)National Key Research and Development Program (No.2017YFC1700102)。
文摘Objective:To systematically evaluate the clinical efficacy of oral Chinese patent medicine combined with sacubitril/valsartan in treating chronic heart failure(CHF).Methods:CNKI,CSPD,CCD,CBM,PubMed,Web of Science,Cochrane Library and EMbase were retrieved to screen out randomized controlled trials Chinese patent medicine and Western medicine in treating CHF.Manual retrieval was also applied as a supplement.The Cochrane Reviewers Handbook 5.1.0 was used to evaluate the bias risk of the included studies and RevMan 5.4 software was used for Meta-analysis.Results:A total of 1301 patients enrolled in the 13 RCTs were included.According to the results of Meta-analysis,a combination of oral Chinese patent medicine and sacubitril/valsartan could further improve total effectiveness rate(RR=1.23,95%CI[1.16,1.30],P<0.001),increase 6 minutes’walk distance(MD=53.04,95%CI[33.43,72.64],P<0.001),improve left ventricular ejection fraction(MD=6.67,95%CI[5.15,8.19],P<0.001)and stroke volume(MD=7.56,95%CI[3.94,11.18],P<0.001),reduce left ventricular end-diastolic dimension(MD=-3.68,95%CI[-4.57,-2.78],P<0.001)and N terminal pro B type natriuretic peptide(MD=-434.08,95%CI[-518.95,-349.22],P<0.001)and no statistically significant difference in drug safety was found between the sacubitril/valsartan-only group and the combined treatment group(RR=0.73,95%CI[0.32,1.65],P=0.45).Conclusion:It’s indicated that a combination of traditional Chinese patent medicine and sacubitril/valsartan had a good clinical efficacy in the treatment of CHF,which had certain guiding significance for clinical practice.
