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目的:系统评价甘露聚糖肽对非小细胞肺癌支持治疗的有效性及安全性。方法:电子检索Co-chrane图书馆、MEDLINE、EMBASE、CNKI、CBMDisc,纳入甘露聚糖肽治疗非小细胞肺癌的随机对照试验。制定严格的纳入排除标准纳入试验研究,评价文献质量,提取数据,并使用RevMan 5.0软件进行Meta分析。结果:纳入16项试验,共有912例患者,其中治疗组475例,对照组435例,结果显示甘露聚糖肽可显著提高化疗的总有效率[59.9%vs 42.3%,OR=2.18,95%CI(1.60,2.95),Z=5.00,P<0.01],亦显著提高肿瘤患者生存质量[67.3%vs 28.9%,OR=5.34,95%CI(2.17,13.16),Z=3.64,P<0.01]及T细胞免疫功能如CD3+[MD=8.36,95%CI(7.24,9.48);Z=14.67,P<0.01],CD4+[MD=13.57,95%CI(5.35,21.79),Z=3.63,P<0.01],CD4+/CD8+[MD=0.70,95%CI(0.56,0.85)Z=9.21,P<0.01]水平;同时能显著降低各种化疗引起的毒副反应如白细胞下降[38.9%vs 59.6%,OR=0.28,95%CI(0.12,0.63),Z=3.08,P<0.01]减少胃肠道不良反应[47.1%vs 73.8%;OR=0.26,95%CI(0.14,0.54),Z=3.73,P<0.01],等,然治疗过程中可引起轻微发热[43.1%vs 2.89%,OR=16.40,95%CI(3.42,78.68),Z=3.50,P<0.01]。结论:甘露聚糖肽可显著提高非小细胞肺癌常规放化疗的近期疗效,提高患者的免疫功能,减轻不良反应,改善生活质量。然上述结论需谨慎对待,需进一步开展更高质量的临床双盲研究予以证实。
OBJECTIVE: To systematically evaluate the efficacy and safety of mannan peptide in the treatment of non-small cell lung cancer. METHODS: Randomized controlled trials of Co-chronological libraries, MEDLINE, EMBASE, CNKI, and CBMDisc were included in the electronic search for the treatment of non-small cell lung cancer with mannan peptides. Develop rigorous inclusion exclusion criteria for inclusion in pilot studies, evaluate the quality of the literature, extract data, and perform meta-analyzes using RevMan 5.0 software. RESULTS: A total of 912 patients were enrolled in 16 trials, of which 475 were in the treatment group and 435 in the control group. The results showed that mannan peptide could significantly improve the overall efficacy of chemotherapy [59.9% vs 42.3%, OR = 2.18, 95% CI (1.60, 2.95), Z = 5.00, P <0.01], but also significantly improved the quality of life of patients with cancer [67.3% vs 28.9%, OR = 5.34,95% CI 2.17,13.16, Z = 3.64, ] And T cell immune function such as CD3 + [MD = 8.36,95% CI (7.24,9.48); Z = 14.67, P <0.01] P <0.01], CD4 + / CD8 + [MD = 0.70,95% CI (0.56,0.85) Z = 9.21, P <0.01]; at the same time, the chemotherapy-induced side effects such as leukopenia OR = 0.28, 95% CI (0.12, 0.63), Z = 3.08, P <0.01] Z = 3.73, P <0.01]. However, slight fever was found during the treatment [43.1% vs 2.89%, OR = 16.40, 95% CI 3.42, 78.68, Z = 3.50, P <0.01]. Conclusion: Mannan peptide can significantly improve the short-term curative effect of conventional radiotherapy and chemotherapy in non-small cell lung cancer, improve the immune function, reduce the adverse reactions and improve the quality of life. However, the above conclusion needs to be treated with caution. Further studies on higher quality of clinical double-blind patients should be carried out.