9种中药注射剂联合肝动脉插管化疗栓塞术治疗原发性肝癌的网状Meta分析

doi:10.13481/j.1671-587x.20160615

摘要/Abstract

摘要：

目的：采用网状Meta分析评价9种中药注射剂联合肝动脉插管化疗栓塞术（TACE）治疗原发性肝癌的有效性和患者生活质量的改善情况。方法：计算机检索Cochrane图书馆、PubMed、EMbase、中国生物医学文献数据库、维普期刊资源数据库、万方数据库和中国知网数据库。检索时间为各数据库建库至2015年12月30日。按照预先制定的纳入和排除标准进行文献筛选，同时评价纳入研究的质量。利用R软件进行统计学分析，采用网状Meta分析方法对纳入的随机对照研究（RCTs）结果进行合并与排序。结果：最终纳入86项RCTs，共计5 791例原发性肝癌患者。网状Meta分析基于概率排序结果显示总有效率由高到低排序依次为：斑螯素注射液（OR=5.60，95% CI：3.55~8.84，P=0.920）、康莱特注射液（OR=5.66，95% CI：2.96~10.82，P=0.906）、榄香烯注射液（OR=3.34，95% CI：1.77~6.32，P=0.601）、复方苦参注射液（OR=2.86，95% CI：1.84~4.46，P=0.478）、鸦胆子油注射液（OR=2.85，95% CI：1.94~4.19，P=0.475）、华蟾素注射液（OR=2.79，95% CI：2.02~3.85，P=0.452）、得力生注射液（OR=2.74，95% CI：1.22~6.15，P=0.448）、艾迪注射液（OR=2.71，95% CI：2.12~3.47，P=0.418）和康艾注射液（OR=2.37，95% CI：1.53~3.66，P=0.301）。生活质量改善的概率排序由高到低依次为：艾迪注射液（OR=3.06，95% CI：1.25~7.47，P=0.669）、康艾注射液（OR=3.38，95% CI：0.50~22.74，P=0.655）、康莱特注射液（OR=2.09，95% CI：0.21~21.38，P=0.599）、得力生注射液（OR=3.33，95% CI：0.05~210.09，P=0.586）、华蟾注射液（OR=2.39，95% CI：0.47~12.26，P=0.556）、鸦胆子油注射液（OR=2.25，95% CI：0.74~6.81，P=0.547）、斑螯素注射液（OR=1.82，95% CI：0.62~5.35，P=0.464）、榄香烯注射液（OR=2.20，95% CI：0.08~62.31，P=0.403）和复方苦参注射液（OR=1.26，95% CI：0.37~4.27，P=0.325）。结论：斑螯素注射液、康莱特注射液和榄香烯注射液较其他6种中药注射液相对有效。艾迪注射液、康艾注射液和康莱特注射液相对其他6种中药注射液改善生活质量较好。

关键词: 肝动脉插管化疗栓塞术, 原发性肝癌, 中药注射剂, 网状Meta分析

Abstract:

Objective: To evaluate the effectiveness of 9 kinds of traditional Chinese herb injections combined with transcatheter arterial chemoembolization (TACE) in the treatment of hepatocellular carcinoma and improvement of life quality of the patients using network Meta-analysis.Methods: The Cochrane Library, PubMed, EMbase and CBM, VIP Chinese Journal Database, Wanfang database, and CNKI database were searched by computer. The retrieval time for each database was from establishment time to December 30, 2015. The literature were screened according to the pre-established inclusion and exclusion criteria, and the qualities of these included studies were evaluated. R software was used for statistical analysis and the results of randomized controlled trial (RCTs) were combined and sorted by network Meta-analysis.Results: A total of 86 RCTs including 5 791 patients were finally included. Based on the probabilistic ranking results, the total effective rates were arranged in the descending order, Cantharidin Injection (OR=5.60, 95%CI:3.55-8.84, P=0.920), Kanglaite Injection (OR=5.66, 95%CI:2.96-10.82, P=0.906), Elemene injection (OR=3.34, 95%CI:1.77-6.32, P=0.601), Compound Kushen Injection (OR=2.86, 95%CI:1.84-4.46, P=0.478), Brucea Javanica Oil Injection (OR=2.85, 95%CI:1.94-4.19, P=0.475), Cinobufacini Injection(OR=2.79, 95%CI:2.02-3.85, P=0.452), Delisheng Injection (OR=2.74, 95%CI:1.22-6.15, P=0.448), Aidi Injection (OR=2.71, 95%CI:2.12-3.47, P=0.418) and Kangai Injection (OR=2.37, 95%CI:1.55-3.66, P=0.301). The probabilities of improvement of life quality were ranked from high to low order, Aidi Injection (OR=3.06, 95%CI:1.25-7.47, P=0.669), Kangai Injection (OR=3.38, 95%CI:0.50-22.74, P=0.655), Kanglaite Injection (OR=2.09, 95%CI:0.21-21.38, P=0.599), Delisheng Injection (OR=3.33,95%CI:0.05-210.09, P=0.586) and Cinobufagin Injection (OR=2.39,95%CI:0.47-12.26, P=0.556), Brucea Javanica Oil Injection (OR=2.25,95%CI:0.74-6.81, P=0.547), Cantharidin Injection (OR=1.82,95%CI:0.62-5.35, P=0.464), Elemene Injection (OR=2.20,95%CI:0.08-62.31, P=0.403) and Compound Kushen Injection (OR=1.26,95%CI:0.37-4.27, P=0.325).Conclusion: Cantharidin Injection, Kanglaite Injection, and Elemene Injection are more relatively effective than the other six kinds of traditional Chinese herb injections. Aidi Injection, Kangai Injection, and Kanglaite Injection can improve the life quality better than the other six kinds of traditional Chinese herb injections.

Key words: Chinese herb injection, hepatocellular carcinoma, network Meta-analysis, transcatheter arterial chemoembolization

中图分类号:

R273

苏莹莹, 刘莹钰, 张扬雨, 马跃, 杨光, 游玥玥, 付颖利, 寇长贵. 9种中药注射剂联合肝动脉插管化疗栓塞术治疗原发性肝癌的网状Meta分析[J]. 吉林大学学报(医学版), 2016, 42(06): 1126-1131.

SU Yingying, LIU Yingyu, ZHANG Yangyu, MA Yue, YANG Guang, YOU Yueyue, FU Yingli, KOU Changgui. Network Meta-analysis of 9 kinds of Chinese herb injections combined with transcatheter arterial chemoembolization in treatment of hepatocellular carcinoma[J]. Journal of Jilin University Medicine Edition, 2016, 42(06): 1126-1131.

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