鸦胆子油乳注射液结合GP方案治疗非小细胞肺癌疗效和安全性的Meta分析

摘要

目的:系统评价鸦胆子油乳注射液结合吉西他滨联合顺铂方案(Gemcitabine Plus Cisplatin,GP)治疗非小细胞肺癌的临床疗效和安全性.方法:计算机检索中国知网清华同方、万方数据库、维普数据库、中国生物医学文摘、Pubmed等数据库,并手工检索相关领域杂志,时间从建库至2017年03月.搜集关于鸦胆子油乳注射液结合GP方案治疗非小细胞肺癌的随机对照试验.结果:最终纳入12项随机对照试验,共1118例患者.Meta分析结果显示:与单纯GP方案相比,鸦胆子油乳注射液结合GP方案治疗非小细胞肺癌在部分缓解率[OR=1.59,95％ CI(1.23,2.05),P=0.0004]、总缓解率[OR=1.72,95％ CI(1.33,2.22),P＜0.000 1]、KPS (Karnofsky)评分改善[0R=2.59,95％ CI(1.96,3.43),P＜0.000 01]、KPS评分恶化[0R=0.33,95％ CI(0.25,0.46),P＜0.00001]、骨髓抑制发生率[OR=0.48,95％ CI(0.35,0.65),P＜0.000 01]、胃肠道不良反应发生率[OR=0.46,95％ CI(0.23,0.91),P=0.03]方面具有统计学意义.结论:鸦胆子油乳结合GP方案可增加临床疗效、降低骨髓抑制及胃肠道不良反应的作用.%This study was aimed to systematically evaluate the clinical efficacy and safety of brucea javanica oil emulsion injection combined with gemcitabine plus cisplatin (GP) regimen in the treatment of non-small cell lung cancer.Literatures were retrieved from databases of CNKI,Wanfang database,VIP,CBM,Pubmed from the date of database establishment to March 2017.Journals on related fields were also manually searched.The randomized controlled trials (RCTs) of brucea javanica oil emulsion injection combined with GP regimen in the treatment of non-small cell lung cancer were collected.The results showed that there were 12 included RCTs with 1 118 patients.The meta-analysis results showed that compared with single using of GP regimen,there were statistical significance in the partial remission rate [OR =1.59,95％ CI (1.23,2.05),P =0.000 4],the total remission rate [OR =1.72,95％ CI (1.33,2.22),P ＜ 0.000 1],the KPS (Karnofsky) score improvement [OR =2.59,95％ CI (1.96,3.43),P ＜ 0.000 01],the deterioration of KPS score [OR =0.33,95％ CI (0.25,0.46),P ＜ 0.000 01],the incidence of bone marrow suppression [OR =0.48,95％ CI (0.35,0.65),P ＜ 0.000 01],and the incidence of gastrointestinal adverse reactions [OR =0.46,95％ CI (0.23,0.91),P =0.03] by brucea javanica oil emulsion injection combined with GP regimen in the treatment of non-small cell lung cancer.It was concluded that brucea javanica oil emulsion injection combined with GP regimen can increase clinical efficacy,decrease myelosuppression rate and gastrointestinal adverse reactions.