J Ethnopharmacol:中成药艾迪注射液治疗癌症的系统评价和荟萃分析

2022-03-17 August MedSci原创

艾迪注射液是国家食品药品监督管理局批准的中草药注射剂之一,也是中国癌症治疗领域最具竞争力的产品。它由斑蝥、黄芪、人参和刺五加的提取物组成。

癌症是世界上最常见的疾病之一。然而,现有的常规疗法并不能解决癌症治疗中的所有临床问题。在中医药(TCM)领域,中草药注射剂自 1940 年代以来已成为主要剂型之一,并在中国的中西医医院广泛使用。

艾迪注射液(国家食品药品监督管理总局批准文号Z52020236)是中国国家中成药基本医疗保险项目抗癌药(CZ01)类中草药注射剂之一。它也被评为中国癌症治疗最具竞争力的产品。艾迪注射液由贵州益白药业有限公司独家生产,由斑蝥( Mylabris)、黄芪(Astragali Radix)、人参(Ginseng Radix et Rhizoma)和刺五加(Acanthopanacis Senticosi)的提取物组成。主治清热解毒,化瘀散结。

然而,关于艾迪注射液作为治疗或辅助治疗的有益效果以及目标临床条件(如癌症类型和阶段)仍不明确。此概述旨在绘制艾迪注射液治疗癌症的系统评价 (SR),并为临床实践和决策提供总结性证据。

材料和方法:在 7 个数据库中搜索了 2020 年 12 月之前关于艾迪注射液治疗癌症的随机对照试验的 SR 和/或荟萃分析。六位作者成对工作,独立确定研究,收集数据,并根据修订后的评估评估纳入研究的质量多重系统评价 (AMSTAR 2) 和系统评价和元分析的首选报告项目 (PRISMA)。叙述性综合用于证据映射。

结果:纳入艾迪注射液辅助治疗的52个SR,涉及肺癌(20 SR)、肝癌(10)、结直肠癌(7)、胃癌(6)、淋巴瘤(2)、乳腺癌(2)、食道癌(1)、卵巢癌(1),以及不同癌症的混合 (4)。除了一个专注于单独使用艾迪注射液的 SR 外,其他 SR 评估了艾迪注射液与化学疗法 (43)、放射疗法 (4) 或化学/放射学/靶向治疗 (4) 的联合使用。艾迪注射液对生存率 (9)、客观反应率 (44)、生活质量 (42) 以及减少化疗/放疗的副作用 (48) 显示出额外的有益效果。使用 AMSTAR 2 工具,两个评价被评估为低质量,其余的评价为极低的方法学质量,主要是由于缺乏前瞻性注册。PRISMA 在搜索策略报告 (26, 50.0%)、附加分析 (19, 36.5%) 和证据总结 (2, 3.8%) 方面评估报告质量不足。

综上所述,艾迪注射液可能在提高癌症生存率、肿瘤反应、生活质量和减少放化疗的副作用方面发挥辅助有益作用。最常研究的癌症类型是肺癌、肝癌和结直肠癌。然而,较低的方法学和报告质量限制了对研究结果的解释和艾迪注射液的循证临床应用。更精心设计、严格执行和充分报告的 SR 和 RCT 是必要的。

原始出处:

Yang M, Shen C, Zhu SJ, Zhang Y, Jiang HL, Bao YD, Yang GY, Liu JP. Chinese patent medicine Aidi injection for cancer care: An overview of systematic reviews and meta-analyses. J Ethnopharmacol. 2022 Jan 10;282:114656. doi: 10.1016/j.jep.2021.114656. Epub 2021 Sep 20. PMID: 34551361.

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    2022-09-28 jj000001
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    2022-07-07 venlin
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    2022-08-01 yb6560
  7. [GetPortalCommentsPageByObjectIdResponse(id=1787779, encodeId=b1d21e87779e0, content=<a href='/topic/show?id=fa03141591e' target=_blank style='color:#2F92EE;'>#Pharm#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14159, encryptionId=fa03141591e, topicName=Pharm)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Wed Sep 28 12:28:28 CST 2022, time=2022-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1681463, encodeId=84ea1681463a8, content=<a href='/topic/show?id=366b8e2299e' target=_blank style='color:#2F92EE;'>#荟萃#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87229, encryptionId=366b8e2299e, topicName=荟萃)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c12d27855367, createdName=venlin, createdTime=Thu Jul 07 02:28:28 CST 2022, time=2022-07-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1837020, encodeId=6f5f183e020f2, content=<a href='/topic/show?id=1f188e230c5' target=_blank style='color:#2F92EE;'>#荟萃分析#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87230, encryptionId=1f188e230c5, topicName=荟萃分析)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b79433, createdName=fangcong, createdTime=Fri Sep 02 23:28:28 CST 2022, time=2022-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1788463, encodeId=40a01e884633c, content=<a href='/topic/show?id=38e014162e2' target=_blank style='color:#2F92EE;'>#Pharmacol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14162, encryptionId=38e014162e2, topicName=Pharmacol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Fri Jul 22 21:28:28 CST 2022, time=2022-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1908687, encodeId=b9ad190868ec4, content=<a href='/topic/show?id=a8d0141605e' target=_blank style='color:#2F92EE;'>#pharma#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14160, encryptionId=a8d0141605e, topicName=pharma)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Mon Nov 07 07:28:28 CST 2022, time=2022-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1996456, encodeId=0a84199645639, content=<a href='/topic/show?id=ed881120ec8' target=_blank style='color:#2F92EE;'>#MAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11207, encryptionId=ed881120ec8, topicName=MAC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b65161, createdName=yb6560, createdTime=Mon Aug 01 02:28:28 CST 2022, time=2022-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1444763, encodeId=c2ba1444e63e4, content=<a href='/topic/show?id=3d9291459d1' target=_blank style='color:#2F92EE;'>#评价#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91459, encryptionId=3d9291459d1, topicName=评价)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1fee5134542, createdName=huagfeg, createdTime=Sat Mar 19 13:28:28 CST 2022, time=2022-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1586615, encodeId=05c815866157d, content=<a href='/topic/show?id=f87c6499085' target=_blank style='color:#2F92EE;'>#注射液#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64990, encryptionId=f87c6499085, topicName=注射液)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c93417353045, createdName=shijzhiewnjhch, createdTime=Sat Mar 19 13:28:28 CST 2022, time=2022-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1203981, encodeId=df3812039810f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220625/6f4f075937de4c5d9fc7ab3a1bc6d8c2/13a8a29e67044698af1fb74276589093.jpg, createdBy=b5c55099112, createdName=D-House, createdTime=Sat Mar 19 10:03:05 CST 2022, time=2022-03-19, status=1, ipAttribution=)]
    2022-03-19 huagfeg
  8. [GetPortalCommentsPageByObjectIdResponse(id=1787779, encodeId=b1d21e87779e0, content=<a href='/topic/show?id=fa03141591e' target=_blank style='color:#2F92EE;'>#Pharm#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14159, encryptionId=fa03141591e, topicName=Pharm)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Wed Sep 28 12:28:28 CST 2022, time=2022-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1681463, encodeId=84ea1681463a8, content=<a href='/topic/show?id=366b8e2299e' target=_blank style='color:#2F92EE;'>#荟萃#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87229, encryptionId=366b8e2299e, topicName=荟萃)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c12d27855367, createdName=venlin, createdTime=Thu Jul 07 02:28:28 CST 2022, time=2022-07-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1837020, encodeId=6f5f183e020f2, content=<a href='/topic/show?id=1f188e230c5' target=_blank style='color:#2F92EE;'>#荟萃分析#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87230, encryptionId=1f188e230c5, topicName=荟萃分析)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b79433, createdName=fangcong, createdTime=Fri Sep 02 23:28:28 CST 2022, time=2022-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1788463, encodeId=40a01e884633c, content=<a href='/topic/show?id=38e014162e2' target=_blank style='color:#2F92EE;'>#Pharmacol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14162, encryptionId=38e014162e2, topicName=Pharmacol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Fri Jul 22 21:28:28 CST 2022, time=2022-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1908687, encodeId=b9ad190868ec4, content=<a href='/topic/show?id=a8d0141605e' target=_blank style='color:#2F92EE;'>#pharma#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14160, encryptionId=a8d0141605e, topicName=pharma)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Mon Nov 07 07:28:28 CST 2022, time=2022-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1996456, encodeId=0a84199645639, content=<a href='/topic/show?id=ed881120ec8' target=_blank style='color:#2F92EE;'>#MAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11207, encryptionId=ed881120ec8, topicName=MAC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b65161, createdName=yb6560, createdTime=Mon Aug 01 02:28:28 CST 2022, time=2022-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1444763, encodeId=c2ba1444e63e4, content=<a href='/topic/show?id=3d9291459d1' target=_blank style='color:#2F92EE;'>#评价#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91459, encryptionId=3d9291459d1, topicName=评价)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1fee5134542, createdName=huagfeg, createdTime=Sat Mar 19 13:28:28 CST 2022, time=2022-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1586615, encodeId=05c815866157d, content=<a href='/topic/show?id=f87c6499085' target=_blank style='color:#2F92EE;'>#注射液#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64990, encryptionId=f87c6499085, topicName=注射液)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c93417353045, createdName=shijzhiewnjhch, createdTime=Sat Mar 19 13:28:28 CST 2022, time=2022-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1203981, encodeId=df3812039810f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220625/6f4f075937de4c5d9fc7ab3a1bc6d8c2/13a8a29e67044698af1fb74276589093.jpg, createdBy=b5c55099112, createdName=D-House, createdTime=Sat Mar 19 10:03:05 CST 2022, time=2022-03-19, status=1, ipAttribution=)]
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    2022-03-19 D-House

    学习

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