【摘要】 目的 采用循證醫(yī)學(xué)的方法評(píng)價(jià)甘露聚糖肽聯(lián)合順鉑對(duì)比單用順鉑治療惡性胸腔積液的有效性和安全性?！》椒ā∮?jì)算機(jī)檢索中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫、中國(guó)期刊全文數(shù)據(jù)庫、中文科技期刊全文數(shù)據(jù)庫、萬方數(shù)據(jù)庫，收集甘露聚糖肽聯(lián)合順鉑對(duì)比單用順鉑治療惡性胸腔積液的隨機(jī)對(duì)照試驗(yàn)，檢索時(shí)間為各數(shù)據(jù)庫建庫至2011年3月。對(duì)文獻(xiàn)進(jìn)行質(zhì)量評(píng)價(jià)，用RevMan 5.0軟件對(duì)數(shù)據(jù)進(jìn)行Meta分析。 結(jié)果 共納入6項(xiàng)研究，所有文獻(xiàn)質(zhì)量均為C級(jí)。共收入388例患者，Meta分析結(jié)果顯示甘露聚糖肽聯(lián)合順鉑組與單用順鉑組相比，總有效率前者高于后者，差異有統(tǒng)計(jì)學(xué)意義（Plt;0.05）；消化道不良反應(yīng)發(fā)生率兩組組間差異無統(tǒng)計(jì)學(xué)意義（P=0.05）；骨髓抑制發(fā)生率前者低于后者，差異有統(tǒng)計(jì)學(xué)意義（Plt;0.05）；Karnofsky評(píng)分提高率前者高于后者，差異有統(tǒng)計(jì)學(xué)意義（Plt;0.05）?！〗Y(jié)論 系統(tǒng)評(píng)價(jià)表明，甘露聚糖肽聯(lián)合順鉑治療惡性胸腔積液的療效優(yōu)于單用順鉑的方案?！続bstract】 Objective To assess the clinical efficacy and safety of mannatide plus cisplatin treating malignant pleural effusion. Methods Literatures were retrieved from CBM, VIP, CNKI, Wanfang databases by computer. Literatures were enrolled according to inclusion and exclusion criteria, and the quality of studies was evaluated according to the Cochrane Library handbook. The period duration of searching was between the establishment of the databases and March, 2011. Meta-analysis was conducted by RevMan 5.0 software. Results The meta-analysis of 6 included RCT, all ranked C, which involved 388 patients. The Meta-analysis showed that the total effective rate in mannatide plus cisplatin group significantly differed from that in cisplatin group (P＜0.05). There were no significant difference in the adverse reaction of digestive tract between the two intervention groups (P=0.05). The adverse reaction of marrow depression inmannatide plus cisplatin group was much lower than that in cisplatin group (P＜0.05). The increase of KPS in mannatide plus cisplatin group was higher than that in cisplatin group (P＜0.05). Conclusions The analysis indicates mannatide plus cisplatin has a better effect on malignant pleural effusion than single cisplatin. However, the reliability of this review is affected by poor quality of included studies, and large-scale randomized controlled trials of high quality are needed to confirm the conclusions above.
目的系統(tǒng)評(píng)價(jià)甘露聚糖肽對(duì)反復(fù)呼吸道感染的臨床療效及免疫功能的影響。 方法計(jì)算機(jī)檢索TheCochrane Library（2013年第12期）、PubMed、EMbase、CNKI、CBM、VIP和WanFang Data，收集甘露聚糖肽預(yù)防或治療反復(fù)呼吸道感染的隨機(jī)對(duì)照試驗(yàn)（RCT），檢索時(shí)限均為從建庫至2013年12月。由2位研究者按照納入與排除標(biāo)準(zhǔn)篩選文獻(xiàn)，提取數(shù)據(jù)和評(píng)價(jià)納入研究的方法學(xué)質(zhì)量后，采用RevMan 5.1.0軟件進(jìn)行Meta分析。 結(jié)果共納入18個(gè)研究，1 481例患者。與安慰劑組相比，甘露聚糖肽組在總有效率、提升T細(xì)胞水平和提升抗體水平上具有明顯優(yōu)勢(shì)，差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）；與左旋咪唑組相比，甘露聚糖肽組在有效率和提升T細(xì)胞水平方面具有明顯優(yōu)勢(shì)（P＜0.05），但在提升抗體水平上與其相當(dāng)，其差異無統(tǒng)計(jì)學(xué)意義。 結(jié)論甘露聚糖肽可顯著提高反復(fù)呼吸道感染的臨床療效和患者免疫功能。