發(fā)布時(shí)間：2019-06-25 09:31

【摘要】：目的對(duì)藥物去勢(shì)（單用黃體生成素釋放激素類似物）與最大限度雄激素阻斷療法（MAB）在前列腺癌治療中的臨床不良反應(yīng)情況進(jìn)行系統(tǒng)評(píng)價(jià)。 方法檢索Pubmed，Embase，萬(wàn)方數(shù)據(jù)庫(kù)，知網(wǎng)數(shù)據(jù)庫(kù)等，檢索前列腺癌藥物治療的隨機(jī)對(duì)照試驗(yàn)（randomized controlled trials，RCTs）文獻(xiàn)，依據(jù)文獻(xiàn)納入和排除標(biāo)準(zhǔn)，進(jìn)行文獻(xiàn)篩選，選采用Jadad量表對(duì)納入文獻(xiàn)進(jìn)行質(zhì)量評(píng)價(jià)。采用Stata軟件進(jìn)行薈萃分析（meta-analysis），對(duì)計(jì)量資料計(jì)算比值比（OR）與相應(yīng)的95％可信區(qū)間（confidence interval，CI），并對(duì)潛在的發(fā)表偏倚做漏斗圖。 結(jié)果按納入標(biāo)準(zhǔn)篩選，，共納入220個(gè)臨床研究的1384例患者進(jìn)行研究，涉及單用黃體生成素釋放激素類似物和最大限度雄阻斷治療在前列腺癌患者治療中產(chǎn)生不良反應(yīng)等方面的比較。薈萃分析顯示：經(jīng)單用黃體生成素釋放激素類似物治療和MAB治療后不良反應(yīng)中全部癥狀、轉(zhuǎn)氨酶增加、胃腸道毒性和潮熱發(fā)生率等方面沒(méi)有統(tǒng)計(jì)學(xué)差異。與MAB治療相比，單用黃體生成素釋放激素類似物治療在嚴(yán)重并發(fā)癥的發(fā)生率方面要高于MAB治療（OR:0.23;95%CI:0.09-0.58）。 結(jié)論單用黃體生成素釋放激素類似物（LHRH-a）與最大限度雄激素阻斷療法（MAB）兩種療法在用藥后不良反應(yīng)發(fā)生率方面并未有明顯不同，但在嚴(yán)重并發(fā)癥發(fā)生率方面MAB治療可能存在一定優(yōu)勢(shì)。
[Abstract]:Objective to evaluate the clinical adverse reactions of drug castration (LH releasing hormone analogues alone) and maximum androgen blocking therapy (MAB) in the treatment of prostate cancer. Methods Pubmed,Embase, Wanfang database, knowledge network database and (randomized controlled trials,RCTs were searched for prostate cancer drug therapy. According to the criteria of literature inclusion and exclusion, the literature was screened, and the quality of the included literature was evaluated by Jadad scale. Meta-analysis (meta-analysis) was carried out by Stata software, and the ratio (OR) to the corresponding 95% confidence interval (confidence interval,CI) was calculated, and the funnel diagram of the potential publication bias was made. Results A total of 1384 patients were selected according to the inclusion criteria, involving the comparison of the adverse reactions of patients with prostate cancer treated with LH releasing hormone analogues alone and the maximum male blocking therapy. Meta-analysis showed that there was no significant difference in all the adverse reactions, the increase of transaminase, gastrointestinal toxicity and the incidence of hot flashes after treatment with LH-releasing hormone analogues and MAB alone. Compared with MAB, the incidence of serious complications was higher in the treatment of LH-releasing hormone analogues than in the treatment of MAB (OR:0.23;95%CI:0.09-0.58). Conclusion there is no significant difference in the incidence of adverse reactions between LHRH-a alone and (MAB), but MAB may have some advantages in the incidence of severe complications.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R737.25

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