文献类型：期刊文献

中文题名：19种中药注射剂联合TACE治疗中晚期肝细胞癌的网状Meta分析

英文题名：Network Meta-analysis on clinical effect of 19 Chinese herb injections combined with TACE in treatment of advanced hepatocellular carcinoma

作者：李戈[1];赵晨[2];思金华[3];靳英辉[4];何慧晶[2];李天宁[5];商洪才[6];张珺[7]

第一作者：李戈

机构：[1]天津中医药大学中医学院,天津300193;[2]天津中医药大学研究生院,天津300193;[3]天津中医药大学图书馆,天津300193;[4]天津中医药大学护理学院,天津300193;[5]天津医科大学医学检验学院,天津300202;[6]北京中医药大学东直门医院,北京100700;[7]甘肃中医药大学护理学院,甘肃兰州730000

第一机构：天津中医药大学中医学院,天津300193

年份：2016

卷号：42

期号：3

起止页码：57

中文期刊名：兰州大学学报（医学版）

外文期刊名：Journal of Lanzhou University（Medical Sciences）

收录：CSTPCD

基金：国家自然科学基金面上项目(81273935);教育部基金项目(NECT09-0900)

语种：中文

中文关键词：中药注射剂;化疗性栓塞;中晚期肝细胞癌;网状Meta分析

外文关键词：traditional Chinese medicine injection; transarterial chemoembolization; hepatocellular carcinoma; network Meta-analysis;

摘要：目的采用网状Meta分析评价19种中药注射剂联合化疗性栓塞(TACE)治疗中晚期肝细胞癌(HCC)的价值。方法检索Web of Science、EMBASE、Pub Med、中国学术期刊网络出版总库、中国生物医学文献数据库和万方数据期刊论文资源等数据库,纳入中药注射剂联合TACE治疗HCC的随机对照试验,采用Cochrane系统评价指导手册评价纳入的RCT研究质量,采用WinBugs 1.43软件和STATA 13.0软件分析数据。结果共纳入93项研究(6 379例患者),涉及19种中药注射剂。网状Meta分析结果显示:在近期有效率方面,鸦胆子注射液、榄香注射液、艾迪注射液、康艾注射液、华蟾素注射液、胎盘多肽注射液、丹皮酚注射液、康莱特注射液、复方苦参注射液和斑蝥注射液分别联合TACE的近期有效率优于TACE且差异有统计学意义,但中药注射剂联合TACE之间的的差异无统计学意义;参芪注射液、艾迪注射液、康艾注射液、华蟾素注射液、胎盘多肽注射液、康莱特注射液、复方苦参注射液、斑蝥注射液分别联合TACE的近期临床获益率优于TACE且差异有统计学意义,TACE+参芪注射液优于TACE+蟾酥注射液、TACE+艾迪注射液优于TACE+复方苦参注射液和TACE+蟾酥注射液。相对排序显示,复方甘草酸苷、鸦胆子和胎盘多肽注射液疗效较好。结论部分中药注射剂联合TACE治疗中晚期肝细胞癌的近期有效率和临床获益率优于单纯TACE,而复方甘草酸苷、鸦胆子和胎盘多肽注射液较其他16种注射液好,建议结合临床实际情况进行选择。
Objective To assess the clinical effects of 19 Chinese herb injections（CHIs） combined transarterial chemoembolization（TACE） in the treatment of hepatocellular carcinoma using a network Meta- analysis.Methods A comprehensive search of the Web of Science, EMBASE, Pub Med, China Academic Journal Network Publication Database, Chinese Biomedical Literature Database and Wanfang Data Journals Resources was undertaken to identify all the randomized controlled trials that explored clinical effects of CHIs combined TACE in the treatment of hepatocellular carcinoma. Cochrane evaluation system was adopted to screen the RCTs according to the predefined inclusion and exclusion criteria. Data were analyzed by Win BUGS 1.43 software and STATA 13.0 software. Results 93 RCTs including 6 379 patients and 19 CHIs were finally identified.The results of network Meta-analyses showed Elemene injection, injection of Brucea javanica, Addie injection,Kang＇ai injection, Cinobutacini injection, Placenta polypeptide injection, Paeonol injection, Kanglaite injection,Fufangkushen injection and Cantharidin injection combined with TACE were better than TACE alone regarding the short-term effectiveness with significant difference, but there was no significant differences among traditional Chinese medicine injection combined with TACE. The short- term clinical benefit rates of Shenqi injection,Addie injection, Kang ai injection, Cinobutacini injection, Placenta polypeptide injection, Kanglaite injection,compound Matrine injection combined with TACE were better than those of TACE with statistically significant difference. Short-term clinical benefit rates of Shenqi injection and Aidi injection with TACE were better than chansu injection combined with TACE, and Aidi injection with TACE was better than compound Kushen injection combined with TACE. The top-three interventions on short-term clinical effects were compound Glycyrrhizin, Brucea javanica injection and Placenta polypeptide injection. Conclusion The short-term effectiveness and clinical benefit rate of some CHIs combined with TACE were better than TACE in the treatment of advanced hepatocellular carcinoma. Compound glycyrrhizin, Brucea javanica injection and Placenta polypeptide injection are better than other CHIs which can be recommended according to the clinical practice.