[關(guān)鍵詞]
[摘要]
目的 系統(tǒng)評(píng)價(jià)沙利度胺聯(lián)合常規(guī)止吐用于化療所致惡心嘔吐(CINV)的有效性與安全性,為臨床用藥提供循證參考。方法 檢索PubMed、Embase、中國(guó)學(xué)術(shù)期刊全文數(shù)據(jù)庫(kù)(CNKI)、中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù)(CBM)、維普中文期刊全文數(shù)據(jù)庫(kù)(VIP)和萬(wàn)方數(shù)據(jù)庫(kù),收集沙利度胺聯(lián)合常規(guī)止吐(試驗(yàn)組)對(duì)比常規(guī)止吐藥物(對(duì)照組)用于CINV的隨機(jī)對(duì)照試驗(yàn)(RCT),篩選文獻(xiàn)、提取資料后,采用Rev Man 5.3統(tǒng)計(jì)軟件進(jìn)行Meta-分析。結(jié)果 共納入12篇RCTs,1 135例患者。Meta-分析結(jié)果顯示,實(shí)驗(yàn)組抑制急性惡心有效率[OR=1.87,95% CI(1.33,2.65),P<0.01]、延遲性惡心有效率[OR=3.54,95% CI(2.66,4.72),P<0.01]、急性嘔吐有效率[OR=1.93,95% CI(1.16,3.21),P=0.01]和延遲性嘔吐有效率[OR=3.67,95% CI(2.58,5.22),P<0.01]均顯著高于對(duì)照組;安全性方面,消化道功能障礙(便秘)發(fā)生率[OR=1.57,95% CI(1.18,2.08),P=0.01]大于對(duì)照組,其他骨髓抑制、中樞神經(jīng)系統(tǒng)損害、心血管損害及皮膚過(guò)敏反應(yīng)發(fā)生率均無(wú)顯著性差異。結(jié)論 沙利度胺聯(lián)合常規(guī)止吐對(duì)化療所致的急性和延遲性惡心、嘔吐均有效,除可增加便秘的發(fā)生風(fēng)險(xiǎn)外,未增加其他不良反應(yīng)的發(fā)生率。
[Key word]
[Abstract]
Objective To systematically evaluate the efficacy and safety of thalidomide for prevention the chemotherapy induced nausea and vomiting (CINV), and provide evidence-based reference for clinical drug use. Methods RCTs about thalidomide combined with routine antiemetic therapy (test group) vs routine antiemetic therapy (control group) in the treatment of CINV were retrieved from PubMed, Embase, CNKI, Wanfang database and VIP. After data extraction, Meta-analysis was conducted by using RevMan 5.3 statistical software. Results A total of 12 RCTs were included, involving 1 135 patients. Results of Meta-analysis showed that the effectiveness of inhibiting acute nausea[OR=1.87, 95% CI(1.33, 2.65), P<0.01], effectiveness of inhibiting delayed nausea[OR=3.54, 95% CI(2.66, 4.72), P<0.01], effectiveness of inhibiting acute vomiting[OR=1.93, 95% CI(1.16, 3.21), P=0.01] and effectiveness of inhibiting delayed vomiting[OR=3.67, 95% CI(2.58, 5.22), P<0.01] of test group were significantly higher than those of control group; In the safety, incidence of digestive tract dysfunction (constipation)[OR=1.57, 95% CI(1.18, 2.08), P=0.01] of test group were significantly higher than those of control group, and there was no significant difference in the incidence of bone marrow suppression, central nervous system damage, cardiovascular damage and skin allergy between two groups. Conclusion Thalidomide combined with routine antiemetic therapy is effective in treating acute and delayed nausea and vomiting induced by chemotherapy, and except for increasing the risk of constipation, there was no increase in the incidence of other adverse reactions.
[中圖分類號(hào)]
[基金項(xiàng)目]