Wu Jiaming, Liu Yun, Fang Cantu, Zhao Lixian, Lin Lizhu, Lu Liming
Zhongshan Affiliated Hospital, Guangzhou University of Chinese Medicine (Zhongshan Hospital of Traditional Chinese Medicine), Zhongshan 528400, China.
South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510006, China.
Evid Based Complement Alternat Med. 2019 Jun 20;2019:5015824. doi: 10.1155/2019/5015824. eCollection 2019.
Whether traditional Chinese medicine preparation combined therapy can improve the efficacy of chemotherapy is controversial. This meta-analysis evaluates the efficacy of traditional Chinese medicine preparation combined with chemotherapy.
Three databases were searched from inception through August 2018. Eligible randomized controlled trials (RCTs) involving the combined treatment of chemotherapy and traditional Chinese medicine preparation compared to chemotherapy alone for treating cancer were retrieved. The methodological quality of the included RCTs was assessed with Cochrane Collaboration's risk of bias assessment tool. Meta-analysis was adopted to make comprehensive comparisons between the experimental and control groups.
Four RCTs were included in this review, comprising 256 subjects. The majority of the RCTs were judged as being of poor methodological quality. Meta-analysis showed that the combination of traditional Chinese medicine preparation and chemotherapy appeared to be more effective than chemotherapy alone, for the treatment of cancer, as assessed by the disease control rate (RR: 1.41, 95% CI: 1.11 to 1.79) and the objective response rate (RR: 2.71, 95% CI: 1.28 to 5.77). There were no statistically significant differences between the groups in terms of bone marrow suppression (RR: 0.88, 95% CI: 0.57 to 1.37) or gastrointestinal reaction (RR: 1.12, 95% CI 0.75 to 1.69).
Traditional Chinese medicine preparation combined with chemotherapy may improve objective response rates and disease control rates more than chemotherapy alone. The evidence that combined traditional Chinese medicine preparation can reduce the side effects of chemotherapy is insufficient. More rigorous randomized controlled trials are needed to confirm these conclusions.
中药制剂联合疗法能否提高化疗疗效存在争议。本荟萃分析评估中药制剂联合化疗的疗效。
检索了从建库至2018年8月的三个数据库。检索了符合条件的随机对照试验(RCT),这些试验涉及化疗与中药制剂联合治疗与单纯化疗治疗癌症的比较。采用Cochrane协作网的偏倚风险评估工具对纳入的RCT的方法学质量进行评估。采用荟萃分析对实验组和对照组进行综合比较。
本综述纳入了4项RCT,共256名受试者。大多数RCT被判定为方法学质量较差。荟萃分析表明,中药制剂联合化疗在治疗癌症方面似乎比单纯化疗更有效,疾病控制率(RR:1.41,95%CI:1.11至1.79)和客观缓解率(RR:2.71,95%CI:1.28至5.77)可作为评估指标。两组在骨髓抑制(RR:0.88,95%CI:0.57至1.37)或胃肠道反应(RR:1.12,95%CI:0.75至1.69)方面无统计学显著差异。
中药制剂联合化疗可能比单纯化疗更能提高客观缓解率和疾病控制率。中药制剂联合使用可降低化疗副作用的证据不足。需要更严格的随机对照试验来证实这些结论。