地榆升白片(肿瘤科)

地榆升白片国内最好的口服升白制剂之一概况升高白细胞中成药升白有效成分和作用机理明确有效预防和治疗白细胞降低123地榆升白片疗效确切、使用方便、安全性好、价格便宜。用法用量4升高白细胞中成药【主要成份】地榆【功能主治】升高白细胞。用于白细胞减少症。【用量用法】口服，4-6片/次，一日3次，或遵医嘱。【规格】100mg/片，40片/盒。【毒副作用】未见毒副反应。【批准文号】国药准字Z20026497【专利号】90108019.5，独家专利品种升白有效成分明确地榆皂苷地榆皂苷：含有多种具有三萜皂苷结构的化学成分。用于制备治疗或预防人白细胞减少症的药物制剂。专利号：90108019.5——中华人民共和国国家知识产权局发明专利促进造血细胞因子促进骨髓有核细胞的增殖改善造血微环境升白的作用机理清楚地榆皂苷的作用机制地榆皂苷的作用机理stromacellsHematopoieticfactorDirectedproliferationanddifferentiationMaintainthehematopoieticmicroenvironmentEarlyhematopoieticregulatoryfactorLatehematopoieticregulatoryfactorIL-3G-CSFsanguisorbinHematopoieticfactorstobenon-peptidesanguisorbinmedullaTPO-RkaryotaDirectedproliferationanddifferentiation促进造血细胞进入血窦并修复，提高外周血象。增加骨髓造血组织容量，提供了升白组织学基础。明显升高S期细胞数，使骨髓进入增殖状态，升高白细胞和促进骨髓细胞增殖分化。提高小鼠CFU-GM集落的产率，促进造血干祖细胞生长，升高外周血白细胞。降低小鼠骨髓细胞微核率，保护骨髓造血DNA免受损伤，促进修复。有效预防和治疗白细胞降低地榆升白片循证医学证据临床上市应用23年，疗效肯定，应用方便，经济。已发表临床文献70余篇，验证其疗效确切，安全。四川大学华西公共卫生学院流行病学教研室地榆升白片预防和治疗放化疗病人骨髓抑制的疗效与安全性38篇文章，3000余例患者，Meta分析采用Revman5.0统计软件有效预防和治疗白细胞降低地榆升白片地榆升白片预防和治疗放化疗病人骨髓抑制的疗效和安全性的Meta分析四川大学华西公共卫生学院流行病学教研室09年4月肿瘤的治疗手段、常见副作用升白细胞药物的使用现状地榆升白片的作用机理及临床效果研究背景预防用药研究对象：化疗和（或放疗）的恶性肿瘤患者，治疗前白细胞计数在4×109/L以上，依从性好，能坚持完整个预防服药疗程（疗程同放化疗，一般为放、化疗的第1天至结束）。年龄、性别不限，肿瘤类型不限。对照组1.空白或安慰剂对照2.空白或安慰剂，后续补充集落刺激因子3.使用其它升白药物：鲨肝醇、利血生、重组人粒细胞集落刺激因子试验组1.单用地榆升白片2.地榆升白片和其它升白药物联用3.单用地榆升白片，后续补充集落刺激因子（CSF）结局指标及本研究的分析指标（预防用药）白细胞（主要评价指标）骨髓抑制控制率：白细胞减少分度0度人数/该组总观察人数集落刺激因子用量感染率生命质量预防用药：白细胞计数单用地榆升白片VS全部对照，文献8篇，试验组380例、对照组357例StudyorSubgroupchenzhiming2006lihongsheng2003liyouming2004maqiang2005wangshijin2004wangxiangbo2003xuxinhua2005zengzhaoyu2007Total(95%CI)Heterogeneity:Tau²=0.16;Chi²=43.63,df=7(P0.00001);I²=84%Testforoveralleffect:Z=5.25(P0.00001)Mean5.334.945.344.324.034.43.575.21SD1.681.271.470.821.120.392.761.47Total2832339072355832380Mean3.885.114.63.443.2332.623.93SD1.731.091.160.131.040.281.81.71Total3237309048344937357Weight8.4%12.3%11.0%17.7%14.8%17.8%8.3%9.7%100.0%IV,Random,95%CI1.45[0.59,2.31]-0.17[-0.73,0.39]0.74[0.09,1.39]0.88[0.71,1.05]0.80[0.41,1.19]1.40[1.24,1.56]0.95[0.08,1.82]1.28[0.53,2.03]0.91[0.57,1.25]ExperimentalControlMeanDifferenceMeanDifferenceIV,Random,95%CI-4-2024FavoursexperimentalFavourscontrol亚组分析（预防）地榆升白片VS其它升白药物文献4篇，试验组：312例、对照组：206例预防用药：白细胞计数预防用药：骨髓抑制控制率地榆升白片VS全部对照文献19篇，试验组：1236例、对照组：804例StudyorSubgroupchengzhonglin2006hanqiang2004haoxiaoyan2004lihong2007lihongsheng2003liuyeguo2004liyouming2004lizhijiu2006loujianxiang2003maqiang2005maruizhong2004tianguiying2004wangshijin2004wangwei2006xuxiaodong2006xuxinhua2005yuegenming2004yuzhaoan2005zhangenyu2003Total(95%CI)TotaleventsHeterogeneity:Tau²=0.02;Chi²=121.13,df=18(P0.00001);I²=85%Testforoveralleffect:Z=7.12(P0.00001)Events271752012920321724786854534025572519945671236Total321802184432403342929065567240725822051981535Events14140168910186938283754102642121451820804Total241632094237423038889065594838684920051981439Weight4.1%6.5%6.5%4.8%4.3%4.7%4.3%4.6%5.7%5.7%5.3%6.2%5.2%4.4%5.4%5.0%6.4%5.2%5.8%100.0%M-H,Random,95%CI0.26[0.03,0.49]0.11[0.05,0.17]0.12[0.05,0.18]0.44[0.26,0.63]0.35[0.13,0.58]0.37[0.18,0.57]0.32[0.09,0.54]0.33[0.13,0.54]0.42[0.29,0.54]0.44[0.31,0.57]0.26[0.11,0.41]0.03[-0.06,0.12]0.35[0.18,0.51]-0.06[-0.27,0.15]0.17[0.03,0.32]0.19[0.01,0.36]0.18[0.11,0.25]0.53[0.37,0.69]0.48[0.36,0.60]0.27[0.20,0.35]ExperimentalControlRiskDifferenceRiskDifferenceM-H,Random,95%CI-0.5-0.2500.250.5FavoursexperimentalFavourscontrol地榆升白片VS其它升白药文献19篇，试验组840例、对照组793例StudyorSubgroupchengzhonglin2006hanqiang2004haoxiaoyan2004lihong2007lihongsheng2003liuyeguo2004liyouming2004lizhijiu2006loujianxiang2003maqiang2005maruizhong2004tianguiying2004wangshijin2004wangwei2006xuxiaodong2006xuxinhua2005yuegenming2004yuzhaoan2005zhangenyu2003Total(95%CI)TotaleventsHeterogeneity:Tau²=0.02;Chi²=45.68,df=8(P0.00001);I²=82%Testforoveralleffect:Z=4.10(P0.0001)Events27175201292032172478685453402557251994567681Total32180218443240334292906556724072582205198840Events14140168910186938283754102642121451820493Total24163209423742303888906559483868492005198793Weight0.0%0.0%13.9%9.5%0.0%0.0%0.0%8.9%0.0%11.6%0.0%13.0%0.0%8.6%10.9%9.9%13.6%0.0%0.0%100.0%M-H,Random,95%CI0.26[0.03,0.49]0.11[0.05,0.17]0.12[0.05,0.18]0.44[0.26,0.63]0.35[0.13,0.58]0.37[0.18,0.57]0.32[0.09,0.54]0.33[0.13,0.54]0.42[0.29,0.54]0.44[0.31,0.57]0.26[0.11,0.41]0.03[-0.06,0.12]0.35[0.18,0.51]-0.06[-0.27,0.15]0.17[0.03,0.32]0.19[0.01,0.36]0.18[0.11,0.25]0.53[0.37,0.69]0.48[0.36,0.60]0.20[0.10,0.30]ExperimentalControlRiskDifferenceRiskDifferenceM-H,Random,95%CI-0.5-0.2500.250.5FavoursexperimentalFavourscontrol预防用药：骨髓抑制控制率亚组分析（预防）预防用药：CSF用量地榆升白片VS全部对照文献4篇，试验组：138例、对照组：148例StudyorSubgroupchenzhiminglihonglihongshengzengzhaoyuTotal(95%CI)Heterogeneity:Tau²=0.47;Chi²=21.85,df=3(P0.0001);I²=86%Testforoveralleffect:Z=3.43(P=0.0006)Mean2.892.122.682.98SD1.080.641.281.67Total28324632138Mean4.382.524.214.82SD1.320.861.281.56Total32374237148Weight24.5%27.6%25.5%22.3%100.0%IV,Random,95%CI-1.49[-2.10,-0.88]-0.40[-0.75,-0.05]-1.53[-2.07,-0.99]-1.84[-2.61,-1.07]-1.28[-2.01,-0.55]ExperimentalControlMeanDifferenceMeanDiffere