Department of Nursing, Taipei Veterans General Hospital, Taiwan.
Evid Based Complement Alternat Med. 2011;2011:291843. doi: 10.1093/ecam/nep185. Epub 2011 Jun 7.
While traditional Chinese medicine (TCM) is widely used among Chinese patients with cancer, studies evaluating the effectiveness of TCM using objective indicators are rare. We examined the effectiveness of TCM for liver protection and completion of chemotherapy among patients with cancer receiving chemotherapy. We used a case-control design to examine the medical records of patients with cancer who received chemotherapy in a teaching hospital in Taipei in 2004. A total of 184 courses of chemotherapy among 89 patients were studied. Of the 184 courses, 42 used TCM jointly with chemotherapy served as cases, while the remaining 142 courses served as controls. Outcome variables included counts of cancelled or delayed chemotherapies and liver function (aspartate aminotransferase, AST and alanine aminotransferase, ALT) 1 week before, during and 2 weeks after chemotherapy. Generalized estimating equations were used to analyze the data. Patients who had concomitant TCM with chemotherapy had lower serum ALT and AST during chemotherapy than the controls given that the age, sex, cancer stage, radiotherapy sites, cancer diagnosis and potential hepatotoxicity of the chemotherapeutic drugs were controlled for in the model [β = -3.48, 95% confidence interval (CI) -10.08 to 3.11 for AST; β = -5.95, 95% CI: -11.47 to -0.44 for ALT]. There was no significant difference between the case and control groups for odds of completing one course of chemotherapy. Use of TCM with chemotherapy resulted in protection of the liver during chemotherapy, as manifested by lower serum AST and ALT levels.
虽然传统中医（TCM）在癌症患者中广泛使用，但使用客观指标评估 TCM 有效性的研究却很少。我们研究了 TCM 在保护癌症患者的肝脏和完成化疗方面的效果。我们使用病例对照设计，研究了 2004 年在台北一家教学医院接受化疗的癌症患者的病历。共有 89 名患者的 184 个化疗疗程纳入研究。在这 184 个疗程中，42 个疗程联合使用 TCM 作为病例，而其余 142 个疗程作为对照。结果变量包括化疗取消或延迟次数和化疗前后 1 周及 2 周的肝功能（天冬氨酸转氨酶，AST 和丙氨酸转氨酶，ALT）。采用广义估计方程分析数据。与接受单纯化疗的患者相比，接受化疗联合 TCM 的患者在化疗期间血清 ALT 和 AST 较低，这是因为在模型中控制了年龄、性别、癌症分期、放疗部位、癌症诊断和化疗药物的潜在肝毒性[AST 的β= -3.48，95%置信区间（CI）为-10.08 至 3.11；ALT 的β= -5.95，95%CI：-11.47 至-0.44]。病例组和对照组在完成一个疗程化疗的几率方面没有显著差异。化疗联合 TCM 的使用导致了化疗期间肝脏的保护，表现为血清 AST 和 ALT 水平降低。
