中国药物警戒 ›› 2025, Vol. 22 ›› Issue (2): 169-176.
DOI: 10.19803/j.1672-8629.20240803

• 中药/中成药减毒增效相关循证评价研究专栏 • 上一篇    下一篇

中成药在恶性肿瘤辅助治疗中预防骨髓抑制发生的网状Meta分析

王涵1, 王存轩2, 吕雪海月3, 张丽宁1, 索于思1, 顾知恩1, 王萍1, 金雪晶1,*   

  1. 1北京中医药大学循证医学中心,北京 100029;
    2北京中医药大学岐黄学院,北京 100029;
    3山东体育学院研究生教育学院,山东 济南 250102
  • 收稿日期:2024-10-16 出版日期:2025-02-17 发布日期:2025-02-17
  • 通讯作者: *金雪晶,女,博士,教授,中西医结合循证医学。E-mail：jinxuejing2018@163.com
  • 作者简介:王涵,男,在读硕士,医师,中西医结合循证医学。
  • 基金资助:
    国家重点研发计划（2022YFC3502100）

Chinese Patent Medicines for Preventing Myelosuppression in Adjuvant Treatment of Malignant Tumors: a Systematic Review and Network Meta-Analysis

WANG Han1, WANG Cunxuan2, LYU Xuehaiyue3, ZHANG Lining1, SUO Yusi1, GU Zhi'en1, WANG Ping1, JIN Xuejing1,*   

  1. 1Centre for Evidence-based Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China;
    2Qi-Huang Chinese Medicine School, Beijing University of Chinese Medicine, Beijing 100029, China;
    3Graduate School of Shandong Sport University, Jinan Shandong 250102, China
  • Received:2024-10-16 Online:2025-02-17 Published:2025-02-17

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摘要： 目的 对临床常用、市场销售份额较大、患者负担较小的8种中成药,进行网状Meta分析,以评估其在恶性肿瘤放化疗中对骨髓抑制的保护作用。方法 检索中国知网、万方数据、维普网、SinoMed、Cochrane Library、PubMed、Embase数据库,检索时间为建库至2024年4月9日。纳入实体瘤患者在放化疗过程中使用中成药预防骨髓抑制的随机对照试验（Randomized Controlled Trials, RCTs）。由2名研究者独立筛选文献、提取资料并运用偏倚风险评估工具进行文献质量评价,采用Stata软件进行网状Meta分析。结果 最终纳入48个RCTs,共4 204例患者,涉及地榆升白片、芪胶升白胶囊、复方阿胶浆、复方皂矾丸、贞芪扶正制剂（颗粒、胶囊、冲剂）、生血宝合剂、参芪十一味颗粒、十一味参芪胶囊8种中成药。网状Meta结果显示,地榆升白片、芪胶升白胶囊、复方皂矾丸能够降低骨髓抑制发生率,复方阿胶浆、地榆升白片、贞芪扶正制剂（颗粒、胶囊、冲剂）能够降低白细胞减少发生率。结论 “补气生血”类的中成药在恶性肿瘤辅助治疗的过程中,能够降低骨髓抑制发生率和白细胞减少发生率,其中参芪十一味颗粒、贞芪扶正制剂（颗粒、颗粒、冲剂）、复方阿胶浆在当前证据下对骨髓抑制有更优的保护作用。受纳入研究数量和质量的限制,上述结论尚待更多高质量的RCTs进一步验证。

关键词: 中成药, 复方皂矾丸, 复方阿胶浆, 恶性肿瘤, 骨髓抑制, 白细胞减少, 不良反应

Abstract: Objective To conduct a network Meta-analysis of eight Chinese patent medicines (CPMs) that are commonly used in clinical practice, have a large market share, and are relatively affordable for patients in order to assess their protective effects against myelosuppression in adjuvant radiotherapy and chemotherapy for malignant tumors. Methods CNKI, Wanfang Database, Chinese Science and Technology Journal Database, SinoMed, Cochrane Library, PubMed, and Embase were searched for related literature published from inception to April 9, 2024. Randomized controlled trials (RCTs) in which CPMs were used to prevent myelosuppression during radiotherapy in patients with solid tumors were enrolled. Two researchers independently screened the literature, retrieved the data, and evaluated the quality of the literature using the risk of bias assessment tool. Stata software was used for network Meta-analysis. Results The number of RCTs included was 48 involving a total of 4 204 patients and eight CPMs, namely, Diyu Shengbai tablets, Qijiao Shengbai capsules, compound E Jiao Jiang, compound Zaofan pills, Zhenqi Fuzheng granules (capsule and punch), Shengxuebao mixture, Shenqi Shiyiwei granules and Shiyiwei Shenqi capsules. The results showed that Diyu Shengbai tablets, Qijiao Shengbai capsules, and Fufang Zaofan pills could reduce the incidence of myelosuppression while compound E Jiao Jiang, Diyu Shengbai tablets, and Zhenqi Fuzheng granules could reduce the incidence of leukopenia. Conclusion CPMs of the “buqi shengxue” category can reduce the incidence of myelosuppression and leukopenia during adjuvant treatment of malignant tumors, among which Shenqi Shiyiwei granules, Zhenqi Fuzheng granules (capsule and punch), and compound E Jiao Jiang have the better protective effect against myelosuppression.

Key words: Chinese Patent Medicines, Compound Zaofan Pills, Compound E Jiao Jiang, Malignant Tumor, Myelosuppression, Decrease of White Blood Cells, Adverse Reactions

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