芦荟凝胶预防放射性皮炎效果的Meta分析
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摘要
[目的]系统评价芦荟凝胶预防放射性皮炎的效果。[方法]检索Cochrane Library、PubMed、EMbase、Web of Science、Science Direct、中国生物医学文献数据库(CBM)、万方数据库和中国期刊全文数据库(CNKI)中有关芦荟凝胶预防肿瘤病人放射性皮炎效果的随机对照试验和临床对照试验,并追溯相关参考文献。对纳入文献的方法学质量进行评价,并采用RevMan5.3进行统计分析。[结果]最终纳入5项随机对照试验、1项临床对照试验,共735例接受放射治疗的肿瘤病人。Meta分析结果显示:干预组放射性皮炎总发生率与对照组比较差异无统计学意义[OR=0.57,95%CI(0.14, 2.40),P>0.05];干预组轻度放射性皮炎发生率与对照组比较差异无统计学意义[OR=1.87,95%CI(0.90,3.91),P>0.05];干预组中度放射性皮炎发生率与对照组比较差异无统计学意义[OR=0.47,95%CI(0.15,1.51),P>0.05];干预组重度放射性皮炎发生率与对照组比较差异有统计学意义[OR=0.61,95%CI(0.40,0.93),P<0.05]。[结论]芦荟凝胶能有效预防放射性皮炎向重度发展,但不能有效预防轻中度放射性皮炎,也不能有效降低放射性皮炎发生率。但由于纳入的研究数目不多,研究结果还需要更多大样本、高质量的研究进一步验证。
Objective:To systematically evaluate the effect of aloe on the prevention of radiation induced dermatitis.Methods:Randomized controlled trials and clinical controlled trials on the prevention of radiation induced dermatitis by aloe in Cochrane Library,PubMed,EMBase,Web of Science,Science Direct,CBM,Wanfang database and CNKI were searched.And the relevant references were traced.The methodological quality of literature was evaluated and RevMan5.3 was used for statistical analysis.Results:5 randomized controlled trials and 1 clinical controlled trial were eventually included,involving 735 cancer patients.The results of Meta analysis showed that there was no statistically significant difference in the total incidence of radiation dermatitis between intervention group and control group [OR=0.57, 95%CI(0.14, 2.40), P>0.05]. There was no significant difference in the incidence of mild radiation dermatitis between intervention group and control group [OR=1.87,95%CI(0.90,3.91),P>0.05].There was no significant difference in the incidence of moderate radiation dermatitis between intervention group and control group [OR=0.47,95%CI(0.15,1.51),P>0.05].The incidence of severe radiation dermatitis in intervention group was significantly different from that in the control group[OR=0.61,95%CI(0.40,0.93), P<0.05].Conclusions:Aloe could effectively prevent the development of the severity of radiation induced dermatitis,but it could not effectively prevent mild and moderate radiation dermatitis.And it could not effectively reduce the incidence of radioactive dermatitis.However,due to the small number of included studies,more large samples and high-quality studies are needed to verify the results.
Objective:To systematically evaluate the effect of aloe on the prevention of radiation induced dermatitis.Methods:Randomized controlled trials and clinical controlled trials on the prevention of radiation induced dermatitis by aloe in Cochrane Library,PubMed,EMBase,Web of Science,Science Direct,CBM,Wanfang database and CNKI were searched.And the relevant references were traced.The methodological quality of literature was evaluated and RevMan5.3 was used for statistical analysis.Results:5 randomized controlled trials and 1 clinical controlled trial were eventually included,involving 735 cancer patients.The results of Meta analysis showed that there was no statistically significant difference in the total incidence of radiation dermatitis between intervention group and control group [OR=0.57, 95%CI(0.14, 2.40), P>0.05]. There was no significant difference in the incidence of mild radiation dermatitis between intervention group and control group [OR=1.87,95%CI(0.90,3.91),P>0.05].There was no significant difference in the incidence of moderate radiation dermatitis between intervention group and control group [OR=0.47,95%CI(0.15,1.51),P>0.05].The incidence of severe radiation dermatitis in intervention group was significantly different from that in the control group[OR=0.61,95%CI(0.40,0.93), P<0.05].Conclusions:Aloe could effectively prevent the development of the severity of radiation induced dermatitis,but it could not effectively prevent mild and moderate radiation dermatitis.And it could not effectively reduce the incidence of radioactive dermatitis.However,due to the small number of included studies,more large samples and high-quality studies are needed to verify the results.
引文
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[13] DONNA H,CAROLINE H.Three-arm randomized phase Ⅲ trial:quality aloe and placebo cream versus powder as skin treatment during breast cancer radiation therapy[J].Clin Bre Can,2015,15(3):181-190.
[14] MAUREEN S,WILLIAMS R N.Phase Ⅲ double-blind evaluation of an aloe vera gel as a prophylactic agent for radiation-induced skin toxicity[J].Radiat Oncol,1996,36(2):345-349.
[15] HADDAD M D,AMOUZGAR-HASHEMI M D.Aloe vera for prevention of radiation-induced dermatitis self-control-led clinical trial[J].Curr Oncol,2013,20(4):345-348.
[16] 姚惠娟,邹丽芳,王明珠.芦荟预防恶性肿瘤患者皮肤放射性损伤的效果观察[J].中华护理杂志,2006,41(4):364-365.
[17] 洪金花,汪华萍,刘蓉.芦荟防治放射性皮炎50例疗效分析[J].实用中西医结合临床杂志,2009,9(1):48-49.
[18] 何池义.芦荟的药理作用[J].中国临床药理学与治疗学,2003,8(3):201.
[19] 卢金利,刘小平,杨芳,等.芦荟凝胶抑制大鼠Ⅱ度放射性皮炎发生的机理研究[J].现代肿瘤医学,2006,14(8):930-932.
[20] RICHARDSON J,SMITH J E,MCINTYRE M,et al.Aloe vera for preventing radiation-induced skin reactions:a systematic literature review[J].Clinical Oncology,2005,17(6):478-484.
[2] HYMES S R,STROM E A,FIFE C.Radiation dermatitis:clinical presentation,pathophysiology,and treatment 2006[J].J Am Acad Dermatol,2006,54(1):28-46.
[3] BOUDREAU M D,BELANG F A.An evaluation of the biological and toxicological properties of aloe barbadensis(Miller),aloe vera[J].J Environ Sci Heath C Environ Carcinog Ecotoxicol Rev,2006,24(1):103-154.
[4] BYEON S W,PELLEY R P,ULLRICH S E,et al.Aloe barbadensis extracts reduce the production of interleukin-10 after exposure to ultreviolet radiation[J].J Ivest Dermatol,1998,110(5):811-817.
[5] COLE L,HEARD C.Skin permeation enhancement potential of aloe vera and aproposed mechanism of action based upon size exclusion and pull effect[J].Int J Pharm,2007,333(1/2):10-16.
[6] Cosmetic Ingredient Review Expert Panel.Final report on the safety assessment of aloe and ongensis extract,aloe and ongensis leaf juice,aloe arborescens leaf extract,aloe arborescens leaf juice,aloe arborescens leaf protoplasts,aloe barbadensis flower extract,aloe barbadensis leaf,aloe barbadensis leaf extract,aloe barbadensis leaf juice,aloe barbadensis leaf polysaccharides,aloe barbadensis leaf water,referral leaf extract,aloe ferox leaf juice,and aloe ferox leaf juice extract[J].Int J Toxicol,2007,26(suppl2):1-50.
[7] HEGGERS J P,PELLEY R P,ROBSON M C.Beneficial effects of aloe in wound healing[J].Phytother Res,1993,7:48-52.
[8] OLSEN D L,RAUB W J R,BRADLEY C,et al.The effect of aloe vera gel/mild soap versus mild soap alone in preventing skin reactions in patients undergoing radiation therapy[J].Oncol Nurs Forum,2001,28(3):543-547.
[9] HEGGIE S,BRYANT G P,TRIPCONY L,et al.A phase Ⅲ study on the efficacy of topical aloe vera gel on irradiated breast tissue[J].Cancer Nurs,2002,25(6):442-451.
[10] MERCHANT T E,BOSLEY C,SMITH J,et al.A Phase Ⅲ trial comparing an anionic phospholipid-based cream and aloe vera-based gel in the prevention of radiation dermatitis in pediatric patients[J].Radiat Oncol,2007,2:45.
[11] NYSTROM J,SVENSK AC,LINDHOLM-SETHSON B,et al.Comparison of three instrumental methods for the objective evaluation of radiotherapy induced erythema in breast cancer patients and a study of the effect of skin lotions[J].Acta Oncol,2007,46(7):893-899.
[12] HIGGINS J P T,GREEN S.Cochrane handbook for systematic reviews of interventions version 5.1.0[M].London:The Cochrane Collaboration,2011:1.
[13] DONNA H,CAROLINE H.Three-arm randomized phase Ⅲ trial:quality aloe and placebo cream versus powder as skin treatment during breast cancer radiation therapy[J].Clin Bre Can,2015,15(3):181-190.
[14] MAUREEN S,WILLIAMS R N.Phase Ⅲ double-blind evaluation of an aloe vera gel as a prophylactic agent for radiation-induced skin toxicity[J].Radiat Oncol,1996,36(2):345-349.
[15] HADDAD M D,AMOUZGAR-HASHEMI M D.Aloe vera for prevention of radiation-induced dermatitis self-control-led clinical trial[J].Curr Oncol,2013,20(4):345-348.
[16] 姚惠娟,邹丽芳,王明珠.芦荟预防恶性肿瘤患者皮肤放射性损伤的效果观察[J].中华护理杂志,2006,41(4):364-365.
[17] 洪金花,汪华萍,刘蓉.芦荟防治放射性皮炎50例疗效分析[J].实用中西医结合临床杂志,2009,9(1):48-49.
[18] 何池义.芦荟的药理作用[J].中国临床药理学与治疗学,2003,8(3):201.
[19] 卢金利,刘小平,杨芳,等.芦荟凝胶抑制大鼠Ⅱ度放射性皮炎发生的机理研究[J].现代肿瘤医学,2006,14(8):930-932.
[20] RICHARDSON J,SMITH J E,MCINTYRE M,et al.Aloe vera for preventing radiation-induced skin reactions:a systematic literature review[J].Clinical Oncology,2005,17(6):478-484.