摘要
目的系统评价参芪扶正注射液(Shenqi-fuzheng Injection,SFI)防治化疗诱导心脏毒性(chemotherapy-induced cardiotoxicity,CIC)的有效性。方法检索中国知网(CNKI)、中国生物医学数据库(CBM)、维普、万方、Embase、Medline、Central数据库,检索时间限定为建库至2019年12月,由两名研究者筛选、评估文献和提取数据,通过联系作者获得文献中缺失的数据,采用Review Manager进行Meta分析。结果我们的研究共纳入14篇文献,共有844名患者参加了随机对照试验,Meta分析结果显示,试验组(trial group)相比于对照组(control group)心肌生物标记物更低,包括脑钠肽(BNP)[SMD=-2.32,95%CI(-3.03,-1.60),P <0.01],乳酸脱氢酶(LDH)[SMD=-2.40,95%CI(-4.27,-0.53),P <0.05],肌钙蛋白T(cTnT)[SMD=-3.46,95%CI(-8.57,1.66),P> 0.05],肌酸激酶同工酶(CK-MB)[SMD=-1.97,95%CI(-3.68,-0.27),P <0.05],且有更低的肌钙蛋白T(c TnT)异常的发生风险[RR=0.29,95%CI(0.10,0.85),P <0.05]和更低的心脏毒性的发生风险[RR=0.42,95%CI(0.23,0.76),P <0.01];而且,SFI组有更高的射血分数水平(LVEF)[%,MD=5.13,95%CI(2.71,7.56),P <0.01]和更低的心电图异常风险[RR=0.40,95%CI(0.26,0.60),P <0.01]。在心电图的具体表现上面,SFI的使用降低43%的ST-T改变的发生风险[RR=0.57,95%CI(0.41,0.81),P <0.01]。结论在减少心脏损伤、维持更高水平射血分数、减少心脏毒性发生率及降低心电图异常风险方面,SFI对化疗所致心脏毒性的防治有一定的疗效。
Objective To systematically evaluate the effectiveness of Shenqi Fuzheng Injection(SFI)for theprevention and treatment of chemotherapy-induced cardiotoxicity(CIC).Methods The primary Chinese andforeign databases of CNKI,China Biomedical Database(CBM),VIP,Wanfang,Embase,Medline and Centraldatabases were retrieved from the establishment date to December 2019.Two researchers performed the literaturescreening,literature evaluation and data extraction.The missing data in the literature was obtained by contactingthe author.Meta-analysis was conducted with Review Manager 5.3.Results A total of 14 articles were includedand 844 patients participated in the randomized controlled trial.Meta-analysis showed that the myocardialbiomarkers in the trial group were lower than those in the control group,and the myocardial biomarkers includedbrain natriuretic peptide(BNP)[SMD=-2.32,95%CI(-3.03,-1.60),P<0.01],lactate dehydrogenase(LDH)[SMD=-2.40,95%CI(-4.27,-0.53),P<0.05],troponin T(cTnT)[SMD=-3.46,95%CI(-8.57,1.66),P>0.05],creatine kinase isoenzymes(CK-MB)[SMD=-1.97,95%CI(-3.68,-0.27),P<0.05].The trial group had lower incidence risk of c Tn T abnormality[RR=0.29,95%CI(0.10,0.85),P<0.05],lowerrisk of cardiac toxicity[RR=0.42,95%CI(0.23,0.76),P<0.01],higher left ventricular ejection fraction(LVEF)[MD=5.13,95%CI(2.71,7.56),P<0.01]and lower risk of abnormal ECG[RR=0.40,95%CI(0.26,0.60),P<0.01]than the control group.In terms of the specific manifestations of ECG,the use of SFIreduced the risk of ST-T changes by 43%[RR=0.57,95%CI(0.41,0.81),P<0.01].Conclusion SFI iseffective in reducing cardiac injury,maintaining higher ejection fraction,reducing the incidence of cardiotoxicityand reducing the risk of abnormal ECG.
作者
刘杰
罗莉
杨柱
冷福玉
王颖
吴群
唐东昕
LIU Jie;LUO Li;YANG Zhu;LENG Fu-yu;WANG Ying;WU Qun;TANG Dong-xin(Guiyang Hospital of Guizhou Aviation Group,Guiyang 550006 Guizhou,China;Guizhou University of traditional Chinese Medicine,Guiyang 550002 Guizhou,China)
出处
《中医肿瘤学杂志》
2021年第1期82-89,共8页
Journal of Oncology in Chinese Medicine
基金
贵州省研究生导师工作室(黔教研合GZS字[2016]08)
贵州省中医肿瘤传承与科技创新人才基地(黔人领发[2018]3号)
贵州省高层次创新型人才培养计划(黔科合人才[2016]4032号)
贵州省研究生工作站计划(黔教研合JYSZ字[2014]018)
贵州省科技计划(黔科合SY字[2013]3026号)。
