复方苦参注射液联合顺铂治疗恶性胸腔积液的 Meta 分析

摘要

Objective:To evaluate the effectiveness and safety of compound Kushen injection combined with cispl-atin for treatment of malignant pleural effusion.Methods:Seven databases were searched,including The Cochrane Li-brary,PubMed,Embase,CBM,CNKI,VIP,Wanfang Database and the methodological quality assessment of RCTs in-cluded was conducted according to the methods of Cochrane collaboration.The Meta -analysis was performed by the RevMan 5.3 software.Results:Total of 18 RCTs containing 1 382 patients were finally included.Results showed that the complete remission rate,partial remission rate,overall efficacy rate and KPS scores increasing rates of compound Kushen injection combined with cisplatin were significantly higher than that of cisplatin monotherapy.Compound Kushen injection combined with cisplatin can reduce the occurrence of gastrointestinal adverse reaction,myelosuppres-sion,hepatic functional impairment,renal functional impairment.Conclusion:Compound Kushen injection combined with cisplatin treating malignant pleural effusion is superior to cisplatin monotherapy.For the quality of included stud-ies,the conclusion needs more high -quality clinical researches.%目的：评价复方苦参注射液联合顺铂治疗恶性胸腔积液的近期疗效、生活质量的改善和毒副反应。方法：计算机检索 The Cochrane Library、PubMed、Embase、中国生物医学文献数据库（CBM）、中国期刊全文数据库（CNKI）、维普中文科技期刊全文数据库（VIP）和万方数据库，对符合纳入标准的随机对照试验进行方法学质量评价，采用 RevMan 5．3进行 Meta 分析。结果：共纳入18个研究1382名患者。结果显示，与单用顺铂相比，复方苦参注射液联合顺铂在胸腔积液的完全缓解率[OR ＝2．41，95％CI：1．89～3．06，P ＜0．00001]、部分缓解率[OR＝1．45，95％CI：1．17～1．81，P ＝0．0009]、有效率[OR＝3．69，95％CI：2．88～4．72，P ＜0．00001]、生活质量改善率[OR ＝4．09，95％CI：3．07～5．45，P ＜0．00001]优于顺铂单药；在毒副反应方面，复方苦参注射液联合顺铂能降低胃肠道反应、骨髓抑制、肝功能损害、肾功能损害的发生率。结论：对恶性胸腔积液的治疗，与单用顺铂相比，复方苦参注射液联合顺铂能提高恶性胸腔积液患者的疗效，改善患者的生活质量，降低毒副反应，但受纳入研究的数量及质量的影响，上述结论尚需更多高质量的临床试验来进一步证实。