Shi Rui, Wu Zhishan, Wang Haojia, Zhang Jingyuan, Zhang Fanqin, Stalin Antony, Chen Meilin, Huang Jiaqi, Zhai Yiyan, Zhang Qianqian, Liu Pengyun, Wu Jiarui, Sun Bin, Wu Chunfang
Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China.
Institute of Fundamental and Frontier Sciences, University of Electronic Science and Technology of China, Chengdu, China.
Front Pharmacol. 2022 Sep 16;13:998218. doi: 10.3389/fphar.2022.998218. eCollection 2022.
Systematic evaluation of the clinical efficacy and safety of Brucea javanica oil emulsion injection (BJOEI) in combination with chemotherapy in the treatment of malignant pleural effusion (MPE). The study searched CNKI, Wanfang database, VIP database, SinoMed, PubMed, Embase, the Cochrane Library, and the Web of Science database and retrieved randomized controlled trials (RCTs) on the treatment of MPE with BJOEI in combination with chemotherapy from seven electronic databases from inception to 31 March 2022. Meta-analysis and sensitivity analysis were performed using Revman 5.4 and Stata 13.0 software. Ultimately, 30 RCTs with 2035 patients were included, including 1002 cases in the control group and 1033 cases in the treatment group. The results of the meta-analysis showed that the overall efficacy rate of BJOEI combined with chemotherapy was higher in the treatment of MPE compared with chemotherapy alone ( = 1.45, : 1.36-1.54, < 0.00001). And it could improve the Karnofsky (KPS) score ( = 1.54, : 1.41-1.68, < 0.00001), reduce adverse reactions such as fever ( = 0.82, 95%CI:0.60-1.12), chest pain ( = 0.90, : 0.67-1.21), gastrointestinal reactions ( = 0.70, : 0.57-0.87, < 0.005), and leukopenia ( = 0.51, : 0.43-0.61, < 0.00001). BJOEI combined with chemotherapy has better clinical efficacy than chemotherapy alone in the treatment of MPE. It can further improve KPS score, improve patients' quality of life, and reduce the occurrence of adverse reactions. However, the conclusions of this study need to be confirmed by further randomized, double-blind, controlled trials with large sample size, reasonable design, and strict implementation.
鸦胆子油乳注射液（BJOEI）联合化疗治疗恶性胸腔积液（MPE）的临床疗效和安全性的系统评价。该研究检索了中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、Embase、考克兰图书馆和Web of Science数据库，检索了从建库至2022年3月31日关于BJOEI联合化疗治疗MPE的随机对照试验（RCT）。使用Revman 5.4和Stata 13.0软件进行Meta分析和敏感性分析。最终，纳入30项RCT，共2035例患者，其中对照组1002例，治疗组1033例。Meta分析结果显示，BJOEI联合化疗治疗MPE的总有效率高于单纯化疗（RR = 1.45，95%CI：1.36 - 1.54，P < 0.00001）。并且它可以提高卡氏（KPS）评分（RR = 1.54，95%CI：1.41 - 1.68，P < 0.00001），减少发热（RR = 0.82，95%CI：0.60 - 1.12）、胸痛（RR = 0.90，95%CI：0.67 - 1.21）、胃肠道反应（RR = 0.70，9'5%CI：0.57 - 0.8'7, P < 0.005）和白细胞减少（RR = 0.51，95%CI：0.43 - 0.61，P < 0.00001）等不良反应。BJOEI联合化疗在治疗MPE方面比单纯化疗具有更好的临床疗效。它可以进一步提高KPS评分，改善患者生活质量，并减少不良反应的发生。然而，本研究的结论需要通过进一步大样本量、设计合理且实施严格的随机、双盲、对照试验来证实。
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