Lin Nan, Jiang Xiaoping, Lei Ruobing. Meta-Analysis of Efficacy of Astragalus Injection Combined with Chemotherapy in the Treatment of Children with Acute Lymphoblastic Leukemia. [J]. 26(6):7-11(2020)
DOI:
Lin Nan, Jiang Xiaoping, Lei Ruobing. Meta-Analysis of Efficacy of Astragalus Injection Combined with Chemotherapy in the Treatment of Children with Acute Lymphoblastic Leukemia. [J]. 26(6):7-11(2020) DOI: 10.13407/j.cnki.jpp.1672-108X.2020.06.003.
Meta-Analysis of Efficacy of Astragalus Injection Combined with Chemotherapy in the Treatment of Children with Acute Lymphoblastic Leukemia
Objective: To systematically evaluate the efficacy of astragalus injection combined with chemotherapy in the treatment of children with acute lymphoblastic leukemia (ALL)
so as to provide evidence-based reference for clinical treatment. Methods: PubMed
EMBase
the Cochrane Library
CBM
CNKI
VIP and Wanfang Database were retrieved to collect the randomized controlled trials (RCT) of astragalus injection combined with chemotherapy in the treatment of children with ALL. References included in the literature were tracked. The retrieval time was from the establishment of the database to Aug. 2018. Two reviewers independently selected the trials
extracted the data and evaluated the methodological quality
and Meta-analysis was performed with RevMan5.3 software
and the quality of evidence was evaluated with the GRADE system. Results: A total of 5 RCT were collected
including 423 children. Meta-analysis showed that compared with conventional chemotherapy
astragalus injection combined with chemotherapy could significantly decrease the incidence of minimal residual disease (MRD) ≥1×10-4 in children with ALL (RR=0.53
95%CI: from 0.32 to 0.88
P<0.05) and the incidence of infection (RR=0.59
95%CI: from 0.46 to 0.76
P<0.01) and increase the levels of granulocyte (MD=0.93
95%CI: from 0.55 to 1.31
P<0.01). There was no significant difference in complete remission rate between two groups (RR=1.16
95%CI: from 0.98 to 1.37
P>0.05). According to evaluation of the evidence level based on the GRADE
the evidence level of complete remission rate and incidence of infection was intermediate
the evidence level of incidence of MRD ≥1×10-4 was low
and the evidence level of granulocyte was extremely low. Conclusion: Astragalus injection combined with chemotherapy in the treatment of children with ALL can significantly decrease the incidence of MRD and infection
increase the levels of granulocyte and enhance the ability of anti-infection
yet without advantages in improving the complete remission rate. Due to the small sample size of the included literature
the conclusion still needs to be further verified by high quality and large sample RCT.
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Related Author
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Zhang Dufei
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Related Institution
Hainan Women and Children’s Medical Center, Children’s Hospital of Hainan
Japan Friendship School of Clinical Medicine, Beijing University of Chinese Medicine,, China
Department of Pediatrics, China-Japan Friendship Hospital
GuangzhouWomen and Children’s Medical Center, Guangzhou
Kunming City Maternal and Child Health Hospital, Kunming