Hou Bonan, Liu Rui, Qin Zhen, Luo Dan, Wang Qi, Huang Shuiqing
School of Basic Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Department of Pharmacology, Guiyang Medical University, Guiyang, Guizhou, China.
Evid Based Complement Alternat Med. 2017;2017:3432750. doi: 10.1155/2017/3432750. Epub 2017 Aug 10.
Myelosuppression is a common side effect in cancer patients receiving chemotherapy or radiotherapy. Chinese herbal medicine (CHM) has shown promise in alleviating myelosuppression.
We searched for randomized controlled trials (RCTs) from seven databases without language restriction. We included RCTs in adults, in which hematological toxicity was measured according to WHO criteria and control group underwent chemotherapy and/or radiotherapy and the treatment group was given oral CHM.
We searched 1021 articles from the date of databases inception to October 7, 2016. We selected 14 articles for the final analysis. Pooled data showed that CHM significantly decreased the suppression rate of leukocytes, neutrophils, hemoglobin, and platelets compared with the control group, particularly in grade III-IV toxicity (leukocytes: RR = 0.43, 95% CI = 0.33-0.56; neutrophils: RR = 0.39, 95% CI = 0.27-0.58; hemoglobin: RR = 0.33, 95% CI = 0.18-0.61; platelets: RR = 0.61, 95% CI = 0.39-0.95).
CHM as an adjuvant can alleviate myelosuppression induced by chemotherapy or radiotherapy, reduce grade III-IV toxicity, and maintain therapeutic dose and treatment cycle. However, due to heterogeneity and publication bias, the results should be interpreted with caution and validated by conducting strictly designed multicenter RCTs of high quality and large scale.
骨髓抑制是接受化疗或放疗的癌症患者常见的副作用。中药已显示出缓解骨髓抑制的前景。
我们检索了七个数据库，不限语言，查找随机对照试验（RCT）。纳入成人RCT，其中根据WHO标准测量血液学毒性，对照组接受化疗和/或放疗，治疗组给予口服中药。
我们从数据库建立之日至2016年10月7日检索了1021篇文章。我们选择了14篇文章进行最终分析。汇总数据显示，与对照组相比，中药显著降低了白细胞、中性粒细胞、血红蛋白和血小板的抑制率，尤其是在III-IV级毒性方面（白细胞：RR = 0.43，95%CI = 0.33-0.56；中性粒细胞：RR = 0.39，95%CI = 0.27-0.58；血红蛋白：RR = 0.33，95%CI = 0.18-0.61；血小板：RR = 0.61，95%CI = 0.39-0.95）。
中药作为辅助药物可缓解化疗或放疗引起的骨髓抑制，降低III-IV级毒性，并维持治疗剂量和治疗周期。然而，由于异质性和发表偏倚，结果应谨慎解释，并通过严格设计的高质量大规模多中心RCT进行验证。
