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基于网络Meta分析和多标准决策分析的三种活血化瘀类口服中成药治疗原发性肝癌的效益-风险评估

[Benefit-risk assessment of three oral Chinese patent medicines for activating blood and eliminating mass in treating primary liver cancer based on network Meta-analysis and multi-criteria decision analysis].

作者信息

Zhang Rong-Rong, Fu Yu, Zhao Rui-Xia, Wang Jing-Wen, Fang Yu-Xuan, Shao Ming-Yi

机构信息

the First Clinical Medical College of Henan University of Chinese Medicine Zhengzhou 450046, China the First Affiliated Hospital of Henan University of Chinese Medicine Zhengzhou 450000, China.

the First Affiliated Hospital of Henan University of Chinese Medicine Zhengzhou 450000, China.

出版信息

Zhongguo Zhong Yao Za Zhi. 2024 Jul;49(13):3668-3675. doi: 10.19540/j.cnki.cjcmm.20240409.501.

Abstract

Network Meta-analysis and multi-criteria decision analysis(MCDA) model were performed to evaluate the benefit-risk of Compound Cantharis Capsules, Huisheng Oral Solution, and Jinlong Capsules in the adjuvant treatment of primary liver cancer(PLC). The randomized controlled trial(RCT) of Compound Cantharis Capsules, Huisheng Oral Solution, and Jinlong Capsules in treating PLC were retrieved from CNKI, Wanfang, VIP, Web of Science, PubMed, and Cochrane Library. R 4.2 was employed to conduct a network Meta-analysis, on the basis of which the effect values of the three medicines were obtained by indirect comparison. MCDA was performed to establish the value tree based on the benefit-risk indexes. Hiview 3.2 was used to calculate the benefit values, risk values, and benefit-risk values of the three medicines in treating PLC, and a sensitivity analysis was carried out to evaluate the robustness of the results. Oracle Crystal Ball 11.1 was employed to optimize the evaluation results by Monte Carlo simulation. A total of 39 RCTs were included. The results showed that Compound Cantharis Capsules, Huisheng Oral Solution, and Jinlong Capsules combined with transcatheter arterial chemoembolization(TACE) had the benefit values of 45, 51 and 45, the risk values of 59, 47, and 41, and the benefit-risk values of 52, 49, and 43, respectively. The benefit-risk differences and [95%CI] of Compound Cantharis Capsules vs Huisheng Oral Solution, Compound Cantharis Capsules vs Jinlong Capsules, and Huisheng Oral Solution vs Jinlong Capsules were 3.00[-13.09, 21.82], 9.00[-4.39, 24.62], and 6.00[-8.84, 20.28], respectively. Based on the results of MCDA, Huisheng Oral Solution, Jinlong Capsules, and Compound Cantharis Capsules combined with TACE had the greatest benefit, the greatest risk, and the best overall benefit, respectively. Considering the efficacy and safety, the priority of the three oral Chinese patent medicines combined with TACE for treating PLC followed the trend of Compound Cantharis Capsules, Huisheng Oral Solution, and Jinlong Capsules.

摘要

采用网状Meta分析和多标准决策分析(MCDA)模型评估复方斑蝥胶囊、回生口服液和金龙胶囊在原发性肝癌(PLC)辅助治疗中的获益-风险。从中国知网、万方、维普、Web of Science、PubMed和Cochrane图书馆检索复方斑蝥胶囊、回生口服液和金龙胶囊治疗PLC的随机对照试验(RCT)。使用R 4.2进行网状Meta分析,在此基础上通过间接比较获得三种药物的效应值。进行MCDA以基于获益-风险指标建立价值树。使用Hiview 3.2计算三种药物治疗PLC的获益值、风险值和获益-风险值,并进行敏感性分析以评估结果的稳健性。使用Oracle Crystal Ball 11.1通过蒙特卡洛模拟优化评估结果。共纳入39项RCT。结果显示,复方斑蝥胶囊、回生口服液和金龙胶囊联合经动脉化疗栓塞术(TACE)的获益值分别为45、51和45,风险值分别为59、47和41,获益-风险值分别为52、49和43。复方斑蝥胶囊与回生口服液、复方斑蝥胶囊与金龙胶囊、回生口服液与金龙胶囊的获益-风险差异及[95%CI]分别为3.00[-13.09, 21.82]、9.00[-4.39, 24.62]和6.00[-8.84, 20.28]。基于MCDA结果,回生口服液、金龙胶囊和复方斑蝥胶囊联合TACE分别具有最大获益、最大风险和最佳总体获益。综合疗效和安全性,三种口服中成药联合TACE治疗PLC的优先顺序依次为复方斑蝥胶囊、回生口服液、金龙胶囊。

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