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中药配方联合他莫昔芬与他莫昔芬治疗乳腺增生症的疗效比较:一项随机试验的Meta分析

Therapeutic Effects of a Traditional Chinese Medicine Formula Plus Tamoxifen vs. Tamoxifen for the Treatment of Mammary Gland Hyperplasia: A Meta-Analysis of Randomized Trials.

作者信息

Li Hao-Tian, Liu Hong-Hong, Yang Yu-Xue, Wang Tao, Zhou Xue-Lin, Yu Yang, Li Su-Na, Zheng Yi, Zhang Ping, Wang Rui-Lin, Li Jian-Yu, Wei Shi-Zhang, Li Kun, Li Peng-Yan, Qian Li-Qi

机构信息

Department of Pharmacy, 302 Military Hospital of China, Beijing, China.

International Center for Liver Disease Treatment, 302 Military Hospital of China, Beijing, China.

出版信息

Front Pharmacol. 2018 Feb 2;9:45. doi: 10.3389/fphar.2018.00045. eCollection 2018.

Abstract

As a common disorder that accounts for over 70% of all breast disease cases, mammary gland hyperplasia (MGH) causes a severe problem for the quality of patients' life, and confers an increased risk of breast carcinoma. However, the etiology and pathogenesis of MGH remain unclear, and the safety and efficacy of current western drug therapy for MGH still need to be improved. Therefore, a meta-analysis was conducted by our team to determine whether a TCM formula named Ru-Pi-Xiao in combination with tamoxifen or Ru-Pi-Xiao treated alone can show more prominent therapeutic effects against MGH with fewer adverse reactions than that of tamoxifen. Studies published before June 2017 were searched based on standardized searching rules in several mainstream medical databases. A total of 27 articles with 4,368 patients were enrolled in this meta-analysis. The results showed that the combination of Ru-Pi-Xiao and tamoxifen could exhibit better therapeutic effects against MGH than that of tamoxifen (OR: 3.79; 95% CI: 3.09-4.65; < 0.00001) with a lower incidence of adverse reactions (OR: 0.35; 95% CI: 0.28-0.43; < 0.00001). The results also suggested that this combination could improve the level of progesterone (MD: 2.22; 95% CI: 1.72-2.71; < 0.00001) and decrease the size of breast lump (MD: -0.67; 95% CI: -0.86 to -0.49; < 0.00001) to a greater extent, which might provide a possible explanation for the pharmacodynamic mechanism of Ru-Pi-Xiao plus tamoxifen. In conclusion, Ru-Pi-Xiao and related preparations could be recommended as auxiliary therapy combined tamoxifen for the treatment of MGH.

摘要

乳腺增生(MGH)作为一种占所有乳腺疾病病例70%以上的常见病症,给患者生活质量带来严重问题,并增加患乳腺癌的风险。然而,MGH的病因和发病机制仍不清楚,目前西医治疗MGH的安全性和有效性仍有待提高。因此,我们团队进行了一项荟萃分析,以确定名为乳癖消的中药配方联合他莫昔芬或单独使用乳癖消治疗MGH是否比他莫昔芬具有更显著的治疗效果且不良反应更少。根据几个主流医学数据库的标准化检索规则,检索了2017年6月之前发表的研究。本荟萃分析共纳入27篇文章,涉及4368例患者。结果表明,乳癖消与他莫昔芬联合使用对MGH的治疗效果优于他莫昔芬(OR:3.79;95%CI:3.09 - 4.65;P < 0.00001),且不良反应发生率较低(OR:0.35;95%CI:0.28 - 0.43;P < 0.00001)。结果还表明,这种联合用药可以更大程度地提高孕酮水平(MD:2.22;95%CI:1.72 - 2.71;P < 0.00001)并减小乳房肿块大小(MD: - 0.67;95%CI: - 0.86至 - 0.49;P < 0.00001),这可能为乳癖消加他莫昔芬的药效机制提供了一种可能的解释。总之,乳癖消及相关制剂可推荐作为联合他莫昔芬治疗MGH的辅助疗法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7eb/5801403/b8d4cf3803ca/fphar-09-00045-g0001.jpg

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