School of Pharmacy, Dali University, Dali, Yunnan, China.
Department of Pharmacy, The Third People's Hospital of Yunnan Province, Kunming, Yunnan, China.
Medicine (Baltimore). 2023 Oct 6;102(40):e35353. doi: 10.1097/MD.0000000000035353.
Caffeic acid tablets (CFA) are a proprietary Chinese medicine in treating thrombocytopenia. The efficacy and safety of CFA compared with other platelet-raising drugs for the treatment of thrombocytopenia have been widely reported in the literature, but there is no systematic evaluation. Therefore, we designed this meta-analysis to further establish the efficacy and safety of CFA in treating thrombocytopenia.
A computerized search was conducted in the Chinese biomedical database (CBM), Chinese National Knowledge Infrastructure (CNKI), Wanfang database, Chinese Scientific Journal Database (VIP), PubMed, and Web of Science databases using the keywords "caffeic acid tablets" and "thrombocytopenia." All randomized controlled trials were selected for the timeframe of build to 02/2023 and then screened and analyzed using RevMan 5.4 and stata17.0 software.
A total of 35 publications with an overall 2533 patients were included in the study. The results of the meta-analysis showed that CFA were effective in the treatment of thrombocytopenia with a statistically significant difference [relative risk ratio (RR) = 1.24, 95% CI (1.17, 1.31), P < .00001] and in increasing platelet counts [standardized mean difference (SMD) = 1.50, 95% CI (1.09, 1.91), P < .00001], white blood cell count [SMD = 1.08, 95% CI (0.77, 1.39), P < .00001], and neutrophil count [SMD = 0.73, 95% CI (0.19, 1.28), P = .009], and CFA reduced myelosuppression [RR = 0.19, 95% CI (0.1, 0.37), P < .00001] and adverse effects [RR = 0.75, 95% CI (0.58, 0.96), P = .02].
CFA can effectively improve the clinical outcome of patients with thrombocytopenia with a good safety profile and are worth promoting. However, due to the low quality and small sample size of the included literature, a larger sample size and more standardized, high-quality studies are needed to validate these results.
咖啡酸片（CFA）是一种治疗血小板减少症的中药专利药。CFA 与其他升血小板药物治疗血小板减少症的疗效和安全性在文献中已有广泛报道，但尚无系统评价。因此，我们设计了这项荟萃分析，以进一步确定 CFA 治疗血小板减少症的疗效和安全性。
计算机检索中国生物医学文献数据库（CBM）、中国知网（CNKI）、万方数据库、中国科技期刊数据库（VIP）、PubMed 和 Web of Science 数据库，使用关键词“咖啡酸片”和“血小板减少症”。纳入所有研究时限为建库至 2023 年 02 月的随机对照试验，采用 RevMan 5.4 和 stata17.0 软件进行筛选和分析。
共纳入 35 篇文献，共计 2533 例患者。荟萃分析结果显示，CFA 治疗血小板减少症有效，差异有统计学意义[相对危险比（RR）=1.24，95%置信区间（CI）（1.17，1.31），P<0.00001]，且能升高血小板计数[标准化均数差（SMD）=1.50，95%CI（1.09，1.91），P<0.00001]、白细胞计数[SMD=1.08，95%CI（0.77，1.39），P<0.00001]和中性粒细胞计数[SMD=0.73，95%CI（0.19，1.28），P=0.009]，降低骨髓抑制[RR=0.19，95%CI（0.1，0.37），P<0.00001]和不良反应[RR=0.75，95%CI（0.58，0.96），P=0.02]。
CFA 能有效改善血小板减少症患者的临床结局，且安全性良好，值得推广。但由于纳入文献质量较低、样本量较小，还需要更大样本量、更规范和高质量的研究来验证这些结果。
