【摘要】 目的 采用循證醫學的方法評價甘露聚糖肽聯合順鉑對比單用順鉑治療惡性胸腔積液的有效性和安全性。 方法 計算機檢索中國生物醫學文獻數據庫、中國期刊全文數據庫、中文科技期刊全文數據庫、萬方數據庫，收集甘露聚糖肽聯合順鉑對比單用順鉑治療惡性胸腔積液的隨機對照試驗，檢索時間為各數據庫建庫至2011年3月。對文獻進行質量評價，用RevMan 5.0軟件對數據進行Meta分析。 結果 共納入6項研究，所有文獻質量均為C級。共收入388例患者，Meta分析結果顯示甘露聚糖肽聯合順鉑組與單用順鉑組相比，總有效率前者高于后者，差異有統計學意義（Plt;0.05）；消化道不良反應發生率兩組組間差異無統計學意義（P=0.05）；骨髓抑制發生率前者低于后者，差異有統計學意義（Plt;0.05）；Karnofsky評分提高率前者高于后者，差異有統計學意義（Plt;0.05）。 結論 系統評價表明，甘露聚糖肽聯合順鉑治療惡性胸腔積液的療效優于單用順鉑的方案。【Abstract】 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.
ObjectiveTo evaluate clinical efficacy of mannatide for recurrent respiratory tract infection (RRTI) and its influence on immune function. MethodsThe Cochrane Library (Issue 12, 2013), PubMed, EMbase, CNKI, CBM, VIP and WanFang Data were searched for the randomized controlled trials (RCTs) that investigated the clinical and immune effect of mannatide in RRTI from inception to December 2013. Two reviewers independently screened studies according to the inclusion and exclusion criteria, extracted data and evaluated the methodological quality of included studies. Then meta-analysis was performed using the software RevMan 5.1.0. ResultsA total of 18 studies involving 1 481 patients were included. The results of meta-analysis showed that compared with the placebo group, the mannatide group was superior in total effectiveness and improving the levels of T-lymphocyte subsets and antibody (P < 0.05); compared with the levomisole group, the mannatide group was superior in total effectiveness and improving the level of T-lymphocyte subsets (P < 0.05), but not in improveming antibody level. ConclusionMannatide improves clinical efficacy in the treatment of RRTI and patients' immune function.