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中药注射剂治疗子宫内膜癌的疗效比较:贝叶斯网状meta 分析。

Comparative efficacy of Chinese herbal injections for treating endometrial carcinoma: A Bayesian network meta-analysis.

机构信息

Institute of Information on Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China.

School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China.

出版信息

Medicine (Baltimore). 2023 Oct 13;102(41):e34676. doi: 10.1097/MD.0000000000034676.

Abstract

BACKGROUND

In view of the limitations of chemotherapy (CT) for endometrial carcinoma (EC) and the extensive use of Chinese herbal injections (CHIs), this network meta-analysis (NMA) compared the efficacy and safety of 6 CHIs combined with CT for EC.

METHODS

Several electronic databases were searched for randomized controlled trials (RCTs). The retrieval period was from the establishment of the databases to September 18, 2022. The quality of the literature was assessed after data extraction using Review Manager version 5.4. The Stata 13.1 and OpenBUGS3.2.3 software were used for data analysis. Cluster analysis was performed to compare the effect of CHIs between 2 different outcomes.

RESULTS

A total of 25 RCTs with 2023 patients were included. The findings demonstrated that when combined with CT, Aidi, Compound Kushen, Kangai, Eshuyou injection, and Shenmai injection can increase clinical efficacy compared to chemotherapy alone. The KPS level can be raised with aidi injection. Combining CT with injections of Aidi, Shenmai, Huangqi, and Compound Kushen can improve immunological performance. Combining CT with injections of Aidi, Huangqi, and Compound Kushen can lower serum amounts of tumor markers. Kangai injection was regarded as a good option for minimizing negative responses. According to the cluster analysis, the clinical effective rate, the KPS score, the level of CA125, and the clinical effective rate of Kangai injection and Aidi injection combined with CT were all better.

CONCLUSION

Current evidence revealed that CHIs combined with CT have a better impact on patients with EC than CT alone. It's possible that KangAi, Aidi, and Eshuyou infusion are the best CHIs for EC. Additionally, more high-quality RCTs are required in order to further corroborate the findings due to NMA's limitations.

摘要

背景

鉴于化疗(CT)在子宫内膜癌(EC)中的局限性以及中草药注射剂(CHIs)的广泛应用,本网络荟萃分析(NMA)比较了 6 种 CHIs 联合 CT 治疗 EC 的疗效和安全性。

方法

检索了多个电子数据库的随机对照试验(RCTs)。检索时间为从数据库建立到 2022 年 9 月 18 日。使用 Review Manager 版本 5.4 提取数据后评估文献质量。使用 Stata 13.1 和 OpenBUGS3.2.3 软件进行数据分析。聚类分析用于比较两种不同结局下 CHIs 的效果。

结果

共纳入 25 项 RCT,共 2023 例患者。结果表明,与单纯化疗相比,艾迪、复方苦参、康艾、参麦、以及艾舒佑注射液联合 CT 可提高临床疗效。艾迪注射液可提高 KPS 水平。联合 CT 注射艾迪、参麦、黄芪和复方苦参可改善免疫功能。联合 CT 注射艾迪、黄芪和复方苦参可降低血清肿瘤标志物水平。康艾注射液被认为是降低不良反应的较好选择。根据聚类分析,康艾注射液和艾迪注射液联合 CT 的临床有效率、KPS 评分、CA125 水平和临床有效率均更好。

结论

目前的证据表明,CHIs 联合 CT 对 EC 患者的影响优于单纯 CT。康艾、艾迪和艾舒佑输注可能是 EC 最好的 CHIs。由于 NMA 的局限性,需要更多高质量的 RCT 来进一步证实这些发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3341/10578732/54e0b8ff010f/medi-102-e34676-g001.jpg

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