Department of Oncology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China.
Evid Based Complement Alternat Med. 2013;2013:656351. doi: 10.1155/2013/656351. Epub 2013 May 29.
This paper is a systematic review of evidence-based studies of the effectiveness of Chinese herbal medicine (CHM) in the treatment of liver cancer. After a detailed analysis of the literature, five animal studies and four human clinical trials met the criteria for inclusion. Analysis revealed that results of the clinical trials, whilst encouraging, need to be interpreted with caution as problems with study designs may lead to apparent benefits being attributable to various forms of bias. However, as each of the CHM agents used in these studies appeared to be potentially beneficial, further well-designed and controlled randomized clinical trials are warranted. The second part of this review focused on the lessons learned from the relationships between Traditional Chinese Medicine (TCM) theory, TCM Syndrome Differentiation, and modern scientific understanding of mechanisms of action of CHM agents. The understanding of TCM Syndrome Differentiation may allow identification of different patterns of disharmony and may provide important guidance to the prescription of CHM. Furthermore, quality control using both biological and chemical fingerprinting of CHM is important to ensure batch-to-batch consistency to deliver sustained therapeutic benefit. Also, careful assessment of herb-drug interactions is paramount for safety and integrative use of western chemotherapeutic and CHM agents.
这篇论文是对中药(CHM)治疗肝癌的循证研究证据的系统评价。经过对文献的详细分析,有五项动物研究和四项人类临床试验符合纳入标准。分析结果表明,临床试验的结果虽然令人鼓舞,但需要谨慎解释,因为研究设计中的问题可能导致明显的益处归因于各种形式的偏倚。然而,由于这些研究中使用的每一种中药制剂似乎都有潜在的益处,因此需要进行进一步的设计良好且对照的随机临床试验。本综述的第二部分重点介绍了从中医药(TCM)理论、中医证候分类与中药作用机制的现代科学认识之间的关系中吸取的经验教训。对中医证候分类的理解可以识别不同的失调模式,并为中药的处方提供重要指导。此外,使用中药的生物和化学指纹图谱进行质量控制对于确保批次间的一致性以提供持续的治疗益处非常重要。此外,仔细评估草药-药物相互作用对于安全性和整合使用西药化疗药物和中药制剂至关重要。