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血必净注射液治疗放射性肺炎的疗效与安全性的 Meta 分析。

Efficacy and safety of Xuebijing injection for radiation pneumonitis: A meta-analysis.

机构信息

Department of Oncology, Guang'an men Hospital, China Academy of Chinese Medical Sciences, Beijing, China.

Graduate School of Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China.

出版信息

PLoS One. 2022 Jun 1;17(6):e0268819. doi: 10.1371/journal.pone.0268819. eCollection 2022.

Abstract

BACKGROUND

Currently, the treatment of radiation pneumonitis (RP) remains a clinical challenge. Although glucocorticoids are used for RP treatment, they have associated side effects. Xuebijing injection (XBJ) has been widely used for RP treatment in China, but so far no meta-analysis has evaluated its efficacy and safety.

METHODS

PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure, WANFANG database, SinoMED, and China Science and Technology J Database were searched for randomized controlled trials related to XBJ in RP treatment. Two researchers independently conducted literature screening, data extraction, and risk of bias assessment. The outcomes were synthesized and analyzed using the Cochrane Review Manager (RevMan 5.3) software, and a forest plot generated.

RESULT

Eight articles met the eligibility criteria for further data extraction and meta-analysis. A total of 578 patients with RP participated in these studies, including 296 in the experimental group (XBJ+BT), and 282 in the control group (BT). The results of the meta-analysis revealed that compared to the BT group, XBJ+BT significantly increased the total effective rate (n = 578; RR = 1.45, 95% CI: 1.30 to 1.61, p<0.0001), and IL-10 expression (n = 296; MD = 17.62, 95% CI:13.95 to 21.29, p<0.00001), decreased interleukin-6 (IL-6) expression (n = 296; MD = -21.56, 95% CI:-27.37 to -15.76, p<0.00001), that of tumor necrosis factor alpha (n = 246; MD = -25.63, 95% CI:-30.77 to -20.50, p<0.00001), and that of C-reactive protein (n = 296; MD = -48.61, 95% CI:-56.49-40.73, p< 0.00001).

CONCLUSION

Based on our results, we do not recommend XBJ as an adjuvant treatment for RP. Further randomized controlled trials with rigorous design, strict implementation, and standard reporting are needed to further evaluate the efficacy and safety of XBJ for RP treatment.

SYSTEMATIC REVIEW REGISTRATION

INPLASY registration number: INPLASY2020120037.

摘要

背景

目前,放射性肺炎(RP)的治疗仍然是一个临床挑战。虽然糖皮质激素被用于 RP 治疗,但它们存在相关的副作用。血必净注射液(XBJ)已在中国广泛用于 RP 治疗,但迄今为止,尚无荟萃分析评估其疗效和安全性。

方法

检索了PubMed、Cochrane Library、EMBASE、中国知网、万方数据库、SinoMED 和中国科技期刊数据库中与 XBJ 治疗 RP 相关的随机对照试验。两名研究人员独立进行文献筛选、数据提取和偏倚风险评估。使用 Cochrane 评论管理软件(RevMan 5.3)对结果进行综合分析,并生成森林图。

结果

共有 8 篇文章符合进一步数据提取和荟萃分析的纳入标准。共有 578 例 RP 患者参与了这些研究,其中实验组(XBJ+BT)296 例,对照组(BT)282 例。荟萃分析结果显示,与 BT 组相比,XBJ+BT 显著提高了总有效率(n=578;RR=1.45,95%CI:1.30 至 1.61,p<0.0001)和白细胞介素-10 表达(n=296;MD=17.62,95%CI:13.95 至 21.29,p<0.00001),降低了白细胞介素-6(IL-6)表达(n=296;MD=-21.56,95%CI:-27.37 至-15.76,p<0.00001)、肿瘤坏死因子-α(n=246;MD=-25.63,95%CI:-30.77 至-20.50,p<0.00001)和 C-反应蛋白(n=296;MD=-48.61,95%CI:-56.49 至-40.73,p<0.00001)。

结论

根据我们的结果,我们不建议将 XBJ 作为 RP 的辅助治疗。需要进一步进行设计严谨、实施严格、报告规范的随机对照试验,以进一步评估 XBJ 治疗 RP 的疗效和安全性。

系统评价注册

INPLASY 注册号:INPLASY2020120037。

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