本文關(guān)鍵詞： 前列腺癌 地加瑞克 Meta分析　出處：《蘭州大學(xué)》2017年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的:系統(tǒng)的探討促性腺激素釋放激素(GnRH)受體拮抗劑地加瑞克治療前列腺癌的安全性、有效性及不同劑量方案之間的療效評(píng)價(jià)。方法:通過(guò)計(jì)算機(jī)檢索Pub Med、EMBASE、the Cochrane Library、Web of Science等數(shù)據(jù)庫(kù)中的相關(guān)文獻(xiàn),系統(tǒng)地搜索識(shí)別隨機(jī)對(duì)照試驗(yàn)與促性腺激素釋放激素(GnRH)受體拮抗劑地加瑞克(240/80mg vs 240/160mg),促性腺激素釋放激素(GnRH)受體激動(dòng)劑戈舍瑞林、亮丙瑞林等對(duì)治療前列腺癌的療效比較。兩個(gè)獨(dú)立的研究者進(jìn)行文獻(xiàn)篩選,篩選評(píng)估偏差的風(fēng)險(xiǎn),然后根據(jù)預(yù)先制定的納入與排除標(biāo)準(zhǔn)篩選和納入,提取相關(guān)數(shù)據(jù)。分析相關(guān)數(shù)據(jù)使用Manager 5.2軟件。結(jié)果:包含6個(gè)隨機(jī)對(duì)照實(shí)驗(yàn),涉及1204個(gè)患者的7篇文獻(xiàn)是符合納入標(biāo)準(zhǔn)的。系統(tǒng)的分析相關(guān)數(shù)據(jù)表明,相比較240/80 mg(初始劑量240mg;維持劑量80mg)地加瑞克組,用240/160 mg(初始劑量240mg;維持劑量160mg)地加瑞克組治療前列腺癌是更有效的,且不良反應(yīng)率更低。與戈舍瑞林相比較,地加瑞克能夠顯著的降低國(guó)際前列腺癥狀評(píng)分(IPSS)[標(biāo)準(zhǔn)差(SMD)=-0.32,95%CI:-0.51~-0.12,P=0.02],引起的不良反應(yīng)發(fā)生率更低(SMD=-0.28,95%CI:-0.48~-0.07,P=0.008)。地加瑞克抑制睪酮及前列腺特異性抗原水平明顯優(yōu)于亮丙瑞林。結(jié)論:針對(duì)晚期前列腺癌的治療,地加瑞克是一個(gè)有效的選擇。240/160 mg地加瑞克組治療方案優(yōu)于240/80 mg地加瑞克組治療方案。目前迫切的需要制定更嚴(yán)格的隨即對(duì)照實(shí)驗(yàn)來(lái)進(jìn)一步證實(shí)地加瑞克的功效。
[Abstract]:Objective: to investigate the safety of the gonadotropin releasing hormone (GnRH) receptor antagonist Digarek in the treatment of prostate cancer. Methods: a computer search was carried out to find the relevant documents in the database of the Cochrane Library of Science, including Pub Medus, the Cochrane Library of Science, and so on. Systematic search and identification of randomized controlled trials and gonadotropin-releasing hormone (GnRH) receptor antagonist, Digarex 240 / 80 mg vs 240 / 160 mg / g, gonadotropin releasing hormone (GnRH) receptor agonist, GnRH, were performed. Two independent researchers screened the literature to assess the risk of bias, and then screened and included according to pre-established inclusion and exclusion criteria. Manager 5.2 software was used to analyze the relevant data. Results: seven articles including 6 randomized controlled trials involving 1204 patients met the inclusion criteria. A systematic analysis of the relevant data showed that, Compared with 240/80 mg (initial dose 240 mg; maintenance dose 80 mg), the treatment of prostate cancer with 240/160 mg (initial dose 240 mg; maintenance dose 160 mg) was more effective and the adverse reaction rate was lower. Digarek was able to significantly reduce the international prostate symptom score (IPSSS) [standard deviation: SMD-0.32O95 CI-0.51U -0.12P0. 02], and the incidence of adverse reactions was lower than that of SMD-0.2895CI-0.48CI-0.07P0.008.The inhibition of testosterone and prostate specific antigen levels by Diggaric was significantly higher than that of Leurelin. For advanced prostate cancer, Diggaric is an effective choice. 240 / 160mg group is better than 240/80 mg group. There is an urgent need to develop a more rigorous randomized controlled trial to further verify the efficacy of Garek.
【學(xué)位授予單位】：蘭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R737.25

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