Network Meta-analysis of 5 Kinds of TCM Injections in the Treatment of Malignant Pleural Effusion / 中国药房

ABSTRACT

OBJECTIVE:To evaluate therapeutic efficacy of Aidi injection,Compound kushen injection,Kanglaite injection, Elemene injection and Brucea javanica oil emulsion injection in the treatment of malignant pleural effusion(MPE),and to provide evidence-based reference in clinic. METHODS:Retrieved from PubMed,EMBase,Cochrane library,CJFD,Wanfang database and CJFD,RCTs about Aidi injection,Compound kushen injection,Kanglaite injection,Elemene injection and B. javanica oil emulsion injection in the treatment of MPE were collected. Meta-analysis was conducted by using ADDIS 1.16.6 statistical software after data extraction and quality evaluation by modified Jadad scale. RESULTS:A total of 54 RCTs were included,involving 3404 patients. All RCTs were two legs with a total number of 108. Results of network Meta-analysis showed that compared with cisplat-in,Compound kushen injection [OR=2.19,95%CI(1.30,3.76),P<0.05],Elemene injection [OR=3.55,95%CI(2.43,5.32),P<0.05] and B. javanica oil emulsion injection [OR=1.92,95%CI(1.34,2.76),P<0.05] could significantly improve response rate of MPE patients,with statistical significance. Pairwise comparison showed response rate of Elemene injection was significantly higher than that of Aidi injection [OR=0.32,95%CI(0.17,0.56),P<0.05],Kanglaite injection [OR=0.30,95%CI(0.13,0.68),P<0.05] and B. javanica oil emulsion injection [OR=1.85,95%CI(1.10,3.17),P<0.05] in improving response rate. The probability ranking was Elemene injection>Compound kushen injection>B. javanica oil emulsion injection>Aidi injection=Kanglaite injection=cispl-atin. Compared with cisplatin,Aidi injection [OR=0.29,95%CI(0.16,0.54),P<0.05],Compound kushen injection [OR=0.44, 95%CI(0.18,0.96),P<0.05],Elemene injection [OR=0.21,95%CI(0.10,0.44),P<0.05] and B. javanica oil emulsion injection [OR=0.41,95%CI(0.23,0.70),P<0.05] could significantly improve the rate of quality of life improvement in MPE patients,with statistical significance. Pairwise comparison showed the rate of quality of life improvement of Elemene injection in MPE patients was significantly higher than that of Kanglaite injection [OR=4.84,95%CI(1.03,25.01),P<0.05]. The probability ranking was El-emene injection>Aidi injection>Compound kushen injection>B. javanica oil emulsion injection>Kanglaite injection>cisplatin.CONCLUSIONS:All 5 kinds of TCM injection can effective-ly treat MPE and improve the quality of life,among which El-emene injection is mostlikely to be the most effective interven-tion.