榄香烯注射液联合化疗治疗NSCLC临床疗效的Meta分析

摘要

目的:从循证医学的角度系统评价榄香烯注射液联合化疗治疗非小细胞肺癌的疗效和不良反应,为临床应用提供依据.方法:搜集榄香烯注射液联合化疗治疗非小细胞肺癌的临床试验,运用Cochrane图书馆系统评价方法,对纳入研究进行质量评价和Meta分析.结果:Meta分析结果提示榄香烯注射液联合化疗在近期疗效、Kamofsky评分改善方面均优于单纯使用化疗.近期有效率比较OR值为1.77,95％ CI为1.21-2.59；Karnofsky评分改善率比较OR值为1.95,95％ CI为1.09-3.50.榄香烯注射液联合化疗时,Ⅱ度和Ⅱ度以上贫血及肖化道不良反应的发生率也较单用化疗低,但白细胞降低未见差异.贫血比较OR值为0.56,95％ CI为0.34-0.94.消化道反应比较OR值为0.54,95％ CI为0.31-0.93.白细胞下降比较OR值为0.74,95％ CI为0.46-1.20.结论榄香烯注射液联合化疗治疗非小细胞肺癌取得较单纯化疗更好的效果和更低的不良反应发生率.但由于纳入的研究方法学质量低,存在发生偏倚的可能性,需更多设计合理的高质量临床试验加以验证.%Objective:To evaluate the efficacy and safety of Elemene injection to treat non-small cell lung cancer (NSCLC) with chemotherapy systematically from evidence-based medicine(EBM).Methods:We searched the clinical trials of Elemene injection to treat non-small cell lung cancer (NSCLC) with chemotherapy,and completed quality evaluation and Meta-analysis by systematic review method of Cochrane Library.Results:Compared with chemotherapy group,Elemene injection combined with chemotherapy was better in the aspects of short-term efficacy and the improvement of Karnofsky score.The OR was increased at 1.77 (95 ％ CI:1.21-2.59) for short-term efficacy and 1.95 (95 ％ CI:1.09-3.50) for the improvement of Karnofsky score.The frequency of Ⅱ ° and above Ⅱ ° anemia (OR =0.56,95 ％ CI:0.34-0.94) and the adverse reactions of digestive system (OR =0.54,95 ％ CI:0.31 -0.93) decreased in Elemene injection combined with chemotherapy group,but the frequency of leukocyte reduction had no difference between two groups (OR =0.74,95 ％ CI:0.46-1.2).Conclusion:Elemene injection combined with chemotherapy has better efficacy and less adverse reactions than only chemotherapy.But it was very possible to have the bias,so need more clinical trials of rational design and high quality studyes.