Network meta-analysis of Chinese herbal injections combined with the chemotherapy for the treatment of pancreatic cancer.
Network meta-analysis of Chinese herbal injections combined with the chemotherapy for the treatment of pancreatic cancer.
复制标题
中药注射剂联合化疗治疗胰腺癌的网络Meta分析
DOI：
10.1097/md.0000000000007005
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发表时间：
2017-05
期刊：
影响因子：
1.6
通讯作者：
Zhang B
中科院分区：
文献类型：
--
作者：
Zhang D;Wu J;Liu S;Zhang X;Zhang B
背景：本研究旨在通过网络荟萃分析评估中药注射剂联合化疗治疗胰腺癌的有效性和安全性。方法：检索截至2016年11月PubMed、Cochrane图书馆、Embase、中国国家知识基础数据库（CNKI）、万方数据库、中国科学期刊全文数据库（VIP）和中国生物医学文献数据库（SinoMed）中关于CHIs治疗胰腺癌的随机对照试验（RCTs）。采用Cochrane偏倚风险工具进行质量评价，并进行网络meta分析比较不同CHIs联合化疗的有效性和安全性。数据分析采用STATA 12.0和Win-BUGS 1.4软件。结果：共检索278条记录，纳入22项符合条件的rct，涉及1329例患者和9例CHIs。网络meta分析结果显示，与单独化疗相比，复方苦参、康艾或康莱特注射液联合化疗改善成绩状态的概率明显更高。爱地注射液联合化疗对缓解白细胞减少的效果优于单纯化疗。这些组间差异在统计学上是显著的。然而，CHIs联合化疗在临床总疗效、恶心呕吐等方面均不能达到较好的效果。对不良反应（adr）的聚类分析显示，单独化疗和花脓素注射液联合化疗对缓解胰腺癌患者不良反应的效果不如其他CHIs加化疗。结论：目前的证据表明，在化疗基础上使用CHIs可改善胰腺癌患者的运动状态，减少不良反应。
Background: This study sought to use a network meta-analysis to assess the effectiveness and safety of Chinese herbal injections (CHIs) combined with the chemotherapy for the treatment of pancreatic cancer. Methods: Randomized controlled trials (RCTs) regarding CHIs to treat pancreatic cancer were searched in PubMed, the Cochrane library, Embase, the China National Knowledge Infrastructure Database (CNKI), the Wan-Fang Database, the Chinese Scientific Journals Full-text Database (VIP), and the Chinese Biomedical Literature Database (SinoMed) up to November 2016. The quality assessment was conducted by the Cochrane risk of bias tool and network meta-analysis was performed to compare the effectiveness and safety of different CHIs combined with the chemotherapy. Data were analyzed using STATA 12.0 and Win-BUGS 1.4 software. Results: A total of 278 records were searched, and 22 eligible RCTs involving 1329 patients and 9 CHIs were included. The results of the network meta-analysis demonstrated that compared with the chemotherapy alone, Compound Kushen, Kangai or Kanglaite injection combined with chemotherapy yielded significantly higher probability of improving performance status. Aidi injection combined with chemotherapy was more effective in relieving leucopenia than using chemotherapy single. And these between-group differences were statistically significant. However, CHIs combined with chemotherapy could not achieve a better effect in the total clinical effect, nausea and vomiting. As for the cluster analysis for the adverse reactions (ADRs), the chemotherapy alone and Huachansu injection combined with the chemotherapy were inferior to relieve ADRs than the other CHIs plus chemotherapy for patients with pancreatic cancer. Conclusions: The current evidence showed that using CHIs on the basis of the chemotherapy could be beneficial for patients with pancreatic cancer in improving performance status and reducing the ADRs.