中药复方防治乳腺癌化疗药心脏毒性的系统评价

doi:10.19803/j.1672-8629.20240449

摘要/Abstract

摘要： 目的以乳腺癌患者化疗为切入,系统评价中药复方防治化疗药心脏毒性的处方应用与疗效,以期为中药防治心脏毒性提供参考。方法在国内外期刊文献数据库中,收集自建库至2024年4月1日已公开发表中药复方对抗乳腺癌患者化疗心脏毒性的临床随机对照试验（RCTs）,采用Excel表分析用药情形。采用RevMan 5.4软件对符合纳入标准的RCTs进行Meta分析。结果纳入42项RCTs,共计受试者2 847例。试验组均在常规化疗用药基础上联用中药复方以对抗化疗药心脏毒性。与仅用化疗药的对照组对比,试验组显著降低心电图异常的发生率OR=0.23[95%CI(0.19, 0.28), P<0.000 01],并且可提升左室射血分数MD=9.02[95%CI(6.45, 11.60), P=0.000 1],还可降低肌酸激酶同工酶和肌钙蛋白I的表达量。结论具有益气养阴、活血通脉效用的中药复方在防治化疗药心脏毒性方面有着较好的优势,为化疗药心脏毒性的中药药物警戒奠定了基础。

关键词: 中药复方, 心脏毒性, Meta分析, 乳腺癌, 临床随机对照试验, 化学疗法, 药物警戒

Abstract: Objective To evaluate the applicability and therapeutic effect of Chinese herbal compounds in preventing and treating chemotherapy-induced cardiotoxicity in breast cancer patients. Methods Data on randomized controlled trials (RCTs) of Chinese herbal compounds for chemotherapy-induced cardiotoxicity in breast cancer patients published in domestic and foreign databases was collected and sortde from establishment of the tibrary to April 1, 2024. Excel sheet was used to analyze the related medications while RevMan 5.4 software was adopted to perform Meta-analysis on RCTs that met the inclusion criteria. Results A total of 42 RCTs were included, involving 2 847 subjects. The experimental group was treated with Chinese herbal compounds plus conventional chemotherapy to combat chemotherapy-induced cardiotoxicity. Compared with the control group treated with chemotherapy drugs alone, the incidence of abnormal electrocardiograms was significantly reduced in the experimental group OR=0.23[95%CI (0.19, 0.28), P<0.000 01]. In addition, the left ventricular ejection fraction was increased with an MD of 9.02[95%CI (6.45, 11.60), P=0.000 1], but the expressions of creatine kinase isoenzyme and troponin I were reduced. Conclusion Chinese herbal compounds capable of replenishing qi and nourishing yin, promoting blood circulation and unblocking meridians have prominent advantages in preventing and treating the cardiotoxicity induced by chemotherapy drugs.

Key words: Chinese Herbal Compound, Cardiotoxicity, Meta-analysis, Breast Cancer, RCTS, Chemotherapy, Pharmacovigilance

中图分类号:

刘淑佳, 张晓朦, 陈思颖, 蔡海丽, 张冰. 中药复方防治乳腺癌化疗药心脏毒性的系统评价[J]. 中国药物警戒, 2024, 21(11): 1209-1215.

LIU Shujia, ZHANG Xiaomeng, CHEN Siying, CAI Haili, ZHANG Bing. Systematic Evaluation of Cardiotoxicity of Chinese Herbal Compounds for Breast Cancer Chemotherapy[J]. Chinese Journal of Pharmacovigilance, 2024, 21(11): 1209-1215.

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