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目的:评价中药外洗预防奥沙利铂所致周围神经毒性的临床疗效和安全性。方法:电子检索中文数据库(CBM、CNKI、VIP、万方)及外文数据库(Medline、Embase、CENTRAL),辅以手工检索,获取关于中药外洗预防奥沙利铂所致周围神经毒性的临床随机对照研究。按照纳入、排除标准筛选文献,对最终纳入文献进行资料提取和偏倚风险评估。应用Rev Man5.3软件进行统计学分析。结果:1共纳入25篇中文文献,2025例患者。汇总分析显示:中药外洗能有效减低奥沙利铂所致周围神经毒性的发生(RR=0.62,95%CI:[0.57,0.67],P<0.000 01);但与常规西药治疗对比,差异无统计学意义(P=0.78);中药外洗可提高常规西药治疗的疗效(RR=0.45,95%CI:[0.28,0.71],P=0.000 6)。2中药外洗的不良反应主要是皮肤过敏,其发生率低、症状较轻,与对照组的差异无统计学意义(P=0.06)。结论:中药外洗可有效预防奥沙利铂周围神经毒性的发生,联合常规西药治疗可提高西药的疗效,且无明显严重的不良反应。但受纳入研究的质量和数量限制,本结论尚需更多大样本、严格设计的临床随机对照试验进一步证实。
Objective: To evaluate the clinical efficacy and safety of traditional Chinese medicine (TCM) wash to prevent peripheral neurotoxicity induced by oxaliplatin. Methods: We searched the Chinese database (CBM, CNKI, VIP, Wanfang) and the foreign language database (Medline, Embase, CENTRAL) manually to obtain the clinical randomized clinical trials on the Chinese herbal medicine external wash to prevent peripheral neurotoxicity induced by oxaliplatin Control study. According to the inclusion and exclusion criteria screening of the literature, the final inclusion of information extraction and risk assessment of bias. Use Rev Man5.3 software for statistical analysis. Results: A total of 25 articles were included in the literature, 2025 patients. The pooled analysis showed that external washing can effectively reduce the peripheral neurotoxicity induced by oxaliplatin (RR = 0.62, 95% CI: [0.57,0.67], P <0.000 01), but compared with the conventional western medicine, the difference There was no statistical significance (P = 0.78). Traditional Chinese medicine washings could improve the efficacy of conventional western medicine (RR = 0.45, 95% CI: 0.28, 0.71, P = 0.0006). The side effects of traditional Chinese medicine external washings were mainly skin allergies with low incidence and mild symptoms, with no significant difference from the control group (P = 0.06). Conclusion: External washing of traditional Chinese medicine can effectively prevent peripheral neurotoxicity of oxaliplatin. Combined with conventional western medicine can improve the curative effect of western medicine without obvious serious adverse reactions. However, due to the quality and quantity limitations of the studies included, a larger sample is needed for this conclusion, as evidenced by well-designed clinical randomized controlled trials.