Yang Zongguo, Liao Xian, Lu Yunfei, Xu Qingnian, Tang Bozong, Chen Xiaorong, Yu Yongchun
Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China.
Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.
Evid Based Complement Alternat Med. 2017;2017:3428253. doi: 10.1155/2017/3428253. Epub 2017 Jun 7.
Traditional Chinese medicine (TCM) therapy for hepatocellular carcinoma remains controversial. This study aimed to evaluate the efficacy and safety of TCM regimens in HCC treatment.
Randomized controlled trials (RCTs) up to June 1, 2016, of the TCM treatment for hepatocellular carcinoma were systematically identified in PubMed, CNKI, Ovid, Embase, Web of Science, Wanfang, VIP, CBM, AMED, and Cochrane Library databases.
A total of 1010 and 931 patients in 20 RCTs were randomly treated with add-on TCM therapy and conventional therapy, respectively. The additional use of TCM significantly improved six-month, one-year, two-year, and three-year overall survival rates in HCC cases (RR = 1.3, = 0.01; RR = 1.38, = 0.0008; RR = 1.44, < 0.0001; RR = 1.31, = 0.02, resp.). Add-on TCM therapy significantly increased PR rate and total response rate (tRR) and reduced PD rate compared to those in control group (34.4% versus 26.3%, RR = 1.30, = 0.002; 41.6% versus 31.0%, RR = 1.30, < 0.0001; and 16.6% versus 26.5%, RR = 0.64, < 0.0001, resp.). Additionally, TCM combination therapy significantly increased the quality of life (QOL) improvement rate and reduced adverse events including leukopenia, thrombocytopenia, anemia or erythropenia, liver injury, and gastrointestinal discomfort in HCC patients (all < 0.05).
Add-on therapy with TCM could improve overall survival, increase clinical tumor responses, lead to better QOL, and reduce adverse events in hepatocellular carcinoma.
中医治疗肝细胞癌仍存在争议。本研究旨在评估中医方案在肝癌治疗中的疗效和安全性。
截至2016年6月1日，在PubMed、CNKI、Ovid、Embase、Web of Science、万方、维普、中国生物医学文献数据库、AMED和Cochrane图书馆数据库中系统检索中医治疗肝细胞癌的随机对照试验（RCT）。
20项RCT中分别有1010例和931例患者被随机给予中医辅助治疗和传统治疗。中医辅助治疗显著提高了肝癌患者6个月、1年、2年和3年的总生存率（RR = 1.3，P = 0.01；RR = 1.38，P = 0.0008；RR = 1.44，P < 0.0001；RR = 1.31，P = 0.02）。与对照组相比，中医辅助治疗显著提高了部分缓解率（PR）和总缓解率（tRR），并降低了疾病进展率（34.4%对26.3%，RR = 1.30，P = 0.002；41.6%对31.0%，RR = 1.30，P < 0.0001；16.6%对26.5%，RR = 0.64，P < 0.0001）。此外，中医联合治疗显著提高了肝癌患者生活质量（QOL）改善率，并减少了包括白细胞减少、血小板减少、贫血或红细胞减少、肝损伤和胃肠道不适在内的不良事件（均P < 0.05）。
中医辅助治疗可提高肝细胞癌患者的总生存率，增加临床肿瘤缓解率，改善生活质量，并减少不良事件。
