基于数据挖掘的中药治疗表皮生长因子受体抑制剂相关皮疹的用药规律研究
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摘要
目的:基于数据挖掘,探索中药治疗表皮生长因子受体抑制剂(EGFRIs)相关皮疹的用药规律。方法:检索外文数据库PubMed、Web of Science、Cochrane Library、EMBASE和中文数据库中国学术期刊全文数据库(CNKI)、中国生物医学文献数据库(CBMdisc)、万方数据知识服务平台(Wangfang)、维普中文科技期刊数据库(VIP)中关于中药治疗EGFRIs相关皮疹的随机对照试验,对随机对照试验中所用的中药进行频率统计,选取出现频率大于2%的药物,运用Spearman相关分析探索中药的配伍规律,并采用聚类分析挖掘相关聚类方剂组成。结果:最终纳入22项研究的中药方剂,其中频率大于2%的药物有15个,频率最高的是金银花;Spearman相关分析显示相关性较强的药对有9组,相关性极强的是荆芥和生地;聚类分析结果显示3组聚类方剂。结论:中药治疗EGFRIs相关皮疹有规律可循,辨证用药多以祛风、清热、除湿药为主,配伍严谨。聚类分析和Spearman相关分析是挖掘用药规律的可行性方法,但仍需要更多的临床随机对照研究。
Objective: To explore the medication rule of traditional Chinese medicine for rash caused by epidermal growth factor receptor inhibitors(EGFRIs) based on data mining. Methods:Search foreign language database such as PubMed, Web of Science, Cochrane Library, EMBASE and Chinese language database like China National Knowledge Infrastructure(CNKI), China Biology Medicine disc(CBM disc), Wanfang data base(Wanfang)and VIP Database(VIP) for randomized controlled trials of traditional Chinese medicine on rash caused by EGFRIs.Count frequency of using Chinese herbs, select more than 2% frequency for Spearman correlation analysis and clustering analysis. Results: A total of 22 studies were included. There were 15 Chinese herbs of more than 2% frequency, the most of which was Lonicera Japonica.There were 9 pairs of Chinese herbs which have strong correlation, the most of which was Schizonepeta and Rehmannia glutinosa Libosch. Clustering analysis revealed 3 groups of Chinese herbs. Conclusion: The medication rule of traditional Chinese medicine for rash induced by EGFRIs has been found, and clinical doctors often treat rash caused by EGFRIs with Chinese herbs which have functions of dispelling wind evil,clearing heat evil and removing wetness.Spearman correlation analysis and clustering analysis are useful methods for exploring regularity of using traditional Chinese medicine,and we need more clinical randomized controlled trials.
Objective: To explore the medication rule of traditional Chinese medicine for rash caused by epidermal growth factor receptor inhibitors(EGFRIs) based on data mining. Methods:Search foreign language database such as PubMed, Web of Science, Cochrane Library, EMBASE and Chinese language database like China National Knowledge Infrastructure(CNKI), China Biology Medicine disc(CBM disc), Wanfang data base(Wanfang)and VIP Database(VIP) for randomized controlled trials of traditional Chinese medicine on rash caused by EGFRIs.Count frequency of using Chinese herbs, select more than 2% frequency for Spearman correlation analysis and clustering analysis. Results: A total of 22 studies were included. There were 15 Chinese herbs of more than 2% frequency, the most of which was Lonicera Japonica.There were 9 pairs of Chinese herbs which have strong correlation, the most of which was Schizonepeta and Rehmannia glutinosa Libosch. Clustering analysis revealed 3 groups of Chinese herbs. Conclusion: The medication rule of traditional Chinese medicine for rash induced by EGFRIs has been found, and clinical doctors often treat rash caused by EGFRIs with Chinese herbs which have functions of dispelling wind evil,clearing heat evil and removing wetness.Spearman correlation analysis and clustering analysis are useful methods for exploring regularity of using traditional Chinese medicine,and we need more clinical randomized controlled trials.
引文
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[14] 王红岩.外用清热利湿中药治疗表皮生长因子受体拮抗剂相关痤疮样皮疹的临床研究[D].北京中医药大学,2013.
[15] 王富强.片仔癀胶囊治疗EGFRI相关性皮疹的临床疗效及其机制[D].福建中医药大学,2013.
[16] 陈学彰,田华琴,徐海燕,等.中药复方消风散联合复方黄水治疗表皮生长因子受体抑制剂皮肤毒性反应40例疗效研究[J].环球中医药,2014,7(s1):54-55.
[17] 石闻光,周雍明,何莉莎,等.银翘散加减治疗吉非替尼引起的皮疹临床研究[J].中医学报,2014,29(7):954-955.
[18] 王学谦.中医药治疗表皮生长因子受体酪氨酸激酶抑制剂相关皮疹的随机对照研究[D].北京中医药大学,2014.
[19] 陈春霞,王娟,何远清,等.中医辨证护理联合LG09方治疗EGFR-TKI所致皮疹临床观察[J].中医药临床杂志,2015,27(12):1757-1759.
[20] 尹建立,高英霞.荆防败毒散加味配合耳穴干预表皮生长因子抑制剂相关皮肤毒性[J].中国医药指南,2015,13(20):214.
[21] 赵智伟,陈晓杰.四物消风散在表皮生长因子受体抑制剂引起的皮疹治疗中的疗效分析[J].中医临床研究,2015,7(8):22-23.
[22] 张誉华.养肺消疹方治疗肺癌靶向药物相关性皮疹的临床观察[D].北京中医药大学,2015.
[23] 王霖,孙增涛,王燕.新癀片治疗吉非替尼痤疮样皮疹的临床疗效观察及相关机制探讨[J].河北中医,2016,38(12):1872-1876.
[24] 彭艳梅.“止痒平肤液”治疗表皮生长因子受体抑制剂相关皮肤不良反应的随机、对照、多中心临床研究[D].北京中医药大学,2016.
[25] 彭韵.五味消毒饮外敷干预厄洛替尼所致药疹的效果观察[J].湖南中医杂志,2017,33(6):120-122.
[26] 朱兆承,孙太振,王生.加味消风散治疗吉非替尼所致皮疹临床观察[J].实用中医药杂志,2017,33(5):469-471.
[27] 林飞.朴炳奎教授学术思想总结及解毒消疹方治疗肿瘤靶向药所致皮疹的临床研究[D].中国中医科学院,2017.
[28] 许进秀,张明娟,王爱蓉,等.荆防败毒散加味配合耳穴防治表皮生长因子受体抑制剂相关皮肤毒性的临床观察[J].中华中医药学刊,2018,36(2):417-419.
[29] Burtness B,Anadkat M,Basti S,et al.NCCN Task Force report:management of dermatologic and other toxicities associated with EGFR inhibition in patients with cancer[J].J Natl Compr Canc Netw,2009,7(Suppl 1):S5-21;quiz S22-24.
[30] Melosky B,Anderson H,Burkes RL,et al.Pancanadian rash trial:a randomized phase Ⅲ trial evaluating the impact of a prophylactic skin treatment regimen on epidermal growth factor receptor-tyrosine kinase inhibitor-induced skin toxicities in patients with metastatic lung cancer[J].J Clin Oncol,2016,34(8):810-815.
[31] Jatoi A,Dakhil SR,Sloan JA,et al.Prophylactic tetracycline does not diminish the severity of epidermal growth factor receptor (EGFR) inhibitor-induced rash:results from the North Central Cancer Treatment Group (Supplementary N03CB)[J].Support Care Cancer,2011,19(10):1601-1607.
[32] Scope A,Lieb JA,Dusza SW,et al.A prospective randomized trial of topical pimecrolimus for cetuximab-associated acnelike eruption [J].J Am Acad Dermatol,2009,61(4):614-620.
[33] 冯秀丽,许庆华,赵晓云,等.金银花及其复方的体外抑菌活性与体内抗炎作用[J].沈阳药科大学学报,2013,30(1):35-39,62.
[2] Cohen MH,Williams GA,Sridhara R,et al.FDA drug approval summary:gefitinib (ZD1839)(Iressa)tablets[J].Oncologist,2003,8(4):303-306.
[3] Cohen MH,Johnson JR,Chen YF,et al.FDA drug approval summary:erlotinib(Tarceva) tablets[J].Oncologist,2005,10(7):461-466.
[4] Lynch TJ,Kim ES,Eaby B,et al.Epidermal growth factor receptor inhibitor-associated cutaneous toxicities:an evolving paradigm in clinical management[J].Oncologist,2007,12(5):610-621.
[5] Liu HB,Wu Y,Lv TF,et al.Skin rash could predict the response to EGFR tyrosine kinase inhibitor and the prognosis for patients with non-small cell lung cancer:a systematic review and meta-analysis[J].PLoS One,2013,8(1):e55128.
[6] 彭艳梅.表皮生长因子受体拮抗剂相关皮肤不良反应表现及治疗进展[J].中国肿瘤临床,2017,44(13):673-676.
[7] 王家晓,张玉梅.蒲腥解毒汤热湿敷治疗西妥昔单抗所致皮肤不良反应21例疗效观察[J].山东医药,2010,50(47):11.
[8] 张海霖,王国蓉,张仕碧,等.金银花液热湿敷防治放疗加西妥昔单抗致皮肤反应的效果观察[J].中华护理杂志,2010,45(4):307-310.
[9] 邱玉梅.裴氏黄白散治疗易瑞沙所致皮肤不良反应的疗效观察[J].西部中医药,2012,25(11):80-82.
[10] 张静,李崇慧.自拟消疹汤治疗EGFRIs相关皮疹疗效观察[J].中医药临床杂志,2012,24(5):426-427.
[11] 陈端洪.加味枇杷清肺饮治疗EGFR-TKI致皮疹的临床观察[D].黑龙江中医药大学,2012.
[12] 孙韬,杨婕,胡凯文.养肺消疹汤治疗EGFR-TKIs药物相关不良皮肤反应的临床观察[J].现代中医临床,2013,20(6):17-19.
[13] 邓珊明,闫增荣,沈欢嗣,等.清肺排毒凉血药结合外用西药治疗吉非替尼相关皮疹的临床研究[J].上海中医药杂志,2013,47(8):47-48.
[14] 王红岩.外用清热利湿中药治疗表皮生长因子受体拮抗剂相关痤疮样皮疹的临床研究[D].北京中医药大学,2013.
[15] 王富强.片仔癀胶囊治疗EGFRI相关性皮疹的临床疗效及其机制[D].福建中医药大学,2013.
[16] 陈学彰,田华琴,徐海燕,等.中药复方消风散联合复方黄水治疗表皮生长因子受体抑制剂皮肤毒性反应40例疗效研究[J].环球中医药,2014,7(s1):54-55.
[17] 石闻光,周雍明,何莉莎,等.银翘散加减治疗吉非替尼引起的皮疹临床研究[J].中医学报,2014,29(7):954-955.
[18] 王学谦.中医药治疗表皮生长因子受体酪氨酸激酶抑制剂相关皮疹的随机对照研究[D].北京中医药大学,2014.
[19] 陈春霞,王娟,何远清,等.中医辨证护理联合LG09方治疗EGFR-TKI所致皮疹临床观察[J].中医药临床杂志,2015,27(12):1757-1759.
[20] 尹建立,高英霞.荆防败毒散加味配合耳穴干预表皮生长因子抑制剂相关皮肤毒性[J].中国医药指南,2015,13(20):214.
[21] 赵智伟,陈晓杰.四物消风散在表皮生长因子受体抑制剂引起的皮疹治疗中的疗效分析[J].中医临床研究,2015,7(8):22-23.
[22] 张誉华.养肺消疹方治疗肺癌靶向药物相关性皮疹的临床观察[D].北京中医药大学,2015.
[23] 王霖,孙增涛,王燕.新癀片治疗吉非替尼痤疮样皮疹的临床疗效观察及相关机制探讨[J].河北中医,2016,38(12):1872-1876.
[24] 彭艳梅.“止痒平肤液”治疗表皮生长因子受体抑制剂相关皮肤不良反应的随机、对照、多中心临床研究[D].北京中医药大学,2016.
[25] 彭韵.五味消毒饮外敷干预厄洛替尼所致药疹的效果观察[J].湖南中医杂志,2017,33(6):120-122.
[26] 朱兆承,孙太振,王生.加味消风散治疗吉非替尼所致皮疹临床观察[J].实用中医药杂志,2017,33(5):469-471.
[27] 林飞.朴炳奎教授学术思想总结及解毒消疹方治疗肿瘤靶向药所致皮疹的临床研究[D].中国中医科学院,2017.
[28] 许进秀,张明娟,王爱蓉,等.荆防败毒散加味配合耳穴防治表皮生长因子受体抑制剂相关皮肤毒性的临床观察[J].中华中医药学刊,2018,36(2):417-419.
[29] Burtness B,Anadkat M,Basti S,et al.NCCN Task Force report:management of dermatologic and other toxicities associated with EGFR inhibition in patients with cancer[J].J Natl Compr Canc Netw,2009,7(Suppl 1):S5-21;quiz S22-24.
[30] Melosky B,Anderson H,Burkes RL,et al.Pancanadian rash trial:a randomized phase Ⅲ trial evaluating the impact of a prophylactic skin treatment regimen on epidermal growth factor receptor-tyrosine kinase inhibitor-induced skin toxicities in patients with metastatic lung cancer[J].J Clin Oncol,2016,34(8):810-815.
[31] Jatoi A,Dakhil SR,Sloan JA,et al.Prophylactic tetracycline does not diminish the severity of epidermal growth factor receptor (EGFR) inhibitor-induced rash:results from the North Central Cancer Treatment Group (Supplementary N03CB)[J].Support Care Cancer,2011,19(10):1601-1607.
[32] Scope A,Lieb JA,Dusza SW,et al.A prospective randomized trial of topical pimecrolimus for cetuximab-associated acnelike eruption [J].J Am Acad Dermatol,2009,61(4):614-620.
[33] 冯秀丽,许庆华,赵晓云,等.金银花及其复方的体外抑菌活性与体内抗炎作用[J].沈阳药科大学学报,2013,30(1):35-39,62.