OBJECTIVE: To evaluate the efficacy and safety of Mannatide injection in the treatment of malignant pleural effusion systematically.METHODS: Literatures were retrieved from Cochrane Library, Medline, Embase, CNKI, VIP, CBM, databases by computer and from conference papers and thesis by hand.Randomized/quasi-randomized control trials about mannatide in the treatment of malignant pleural effusion were collected.Trial selection, quality evaluation and information extraction were performed according to including and excluding criteria.Meta-analysis was conducted using RevMan 5.0 software.RESULTS: 17 RCTs were included and divided into three sub-groups.Results of Meta-analysis showed: Sub-group A and B were better than control [RR= 1.38,95％CI( 1.27, 1.50) ,P＜0.01], [RR= 1.34, 95％ CI ( 1.17, 1.54), P＜0.01], there was significant difference between two sub-groups.KPS score of trial group was better than control group [RR= 1.82, 95％ CI (1.51, 2.20), P＜0.01].Survival duration of trial group was better than control group (P＜0.05).Adverse drug reactions: results of 17 studies showed that mannatide could reduce myelosuppression, gastrointestinal reaction and pectoralgia caused by platinum antitumor drugs while mannatide maybe cause slight fever, CONCLUSION: Mannatide combination can improve short-term efficacy of platinum antitumor drugs reduce adverse drug reactions and improve life quality while it can induce slight fever.However, due to the limited quality of included studies and publication bias, further study is required through large-scale high-quality and multi-centre randomized double-blind control trials.%目的:系统评价甘露聚糖肽注射液治疗恶性胸腔积液的有效性及安全性.方法:电子检索Cochrane图书馆、Medline、Embase、CNKI、VIP、CBM,手工检索相关杂志、会议论文、学位论文,收集甘露聚糖肽治疗恶性胸腔积液的随机及半随机对照试验.由2名研究者独立选择试验、评价质量、提取数据,并交叉核对.使用RevMan 5.0软件进行Meta分析.结果:纳入17个研究,分为3个亚组,结果显示:(1)近期疗效:亚组A、B中治疗组优于对照组[RR=1138,95%CI(1.27,1.50).P＜0.01].[RR=1.34.95%CI(1.17,1.54),P＜0.01],亚组C中2组差异无统计学意义;(2)KPS评分:治疗组优于对照组[RR=1.82,95%CI(1.51,2.20),P＜0.01];(3)生存期:治疗组优于对照组(P＜0.05);(4)不良反应:使用甘露聚糖肽可能减少由铂类抗肿瘤药引起的骨髓抑制、胃肠道反应及胸痛反应,但其可引起轻微发热.结论:联用甘露聚糖肽可提高铂类抗肿瘤药化疗的近期疗效.减轻不良反应,改善生活质量,但其可引起轻微发热.但由于纳入研究的方法质量较低和可能存在发表偏倚,上述结论有待进一步开展大样本、高质量、多中心的随机双盲对照试验来证实.
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