康艾注射液，一种中药，可提高晚期结直肠癌患者化疗的疗效并降低毒性：一项系统评价和荟萃分析。
Kangai Injection, a Traditional Chinese Medicine, Improves Efficacy and Reduces Toxicity of Chemotherapy in Advanced Colorectal Cancer Patients: A Systematic Review and Meta-Analysis.
作者信息
Huang Siqi, Peng Weijun, Mao Dan, Zhang Shaofan, Xu PanPan, Yi PengJi, Zhang Sifang
机构信息
Department of Integrated Traditional Chinese and Western Internal Medicine, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410000, China.
Department of Oncology, Yueyang Hospital of Traditional Chinese Medicine, Yueyang, Hunan 414000, China.
出版信息
Evid Based Complement Alternat Med. 2019 Jul 15;2019:8423037. doi: 10.1155/2019/8423037. eCollection 2019.
OBJECTIVE
To systematically review whether the Kangai injection (KAI), which is commonly used traditional Chinese medicine, can improve the clinical efficacy of chemotherapy and relieve adverse reactions of chemotherapy in advanced colorectal cancer (CRC) patients.
METHODS
A comprehensive literature search was performed in three English and three Chinese electronic databases until March 2019. The literature was screened by EndNote X8 and data were analysed by RevMan5 and Stata12.0.
RESULTS
This meta-analysis consisted of twenty-eight studies, of which 2310 cases were reported. Among the 2310 cases, 1207 cases were treated with KAI combined with chemotherapy and 1103 cases were treated with chemotherapy alone. The results showed that KAI combined with chemotherapy significantly improved tumor response (Risk Ratio (RR) =1.32; 95% confidence interval (CI): 1.22-1.43; <0.00001); Karnofsky performance status (KPS score) (Risk Ratio (RR) =1.48; 95% CI: 1.36-1.60; <0.00001); reduced adverse drug reactions (ADRs) such as nausea and vomiting (OR =0.31; 95% CI: 0.24-0.41; <0.00001), diarrhea (OR =0.36; 95% CI: 0.25-0.52; <0.00001), leukopenia (OR =2.97; 95% CI:2.27-3.88; <0.00001), thrombocytopenia (OR =0.53; 95% CI: 0.38-0.74; <0.0002), liver dysfunction (OR =0.29; 95% CI: 0.20-0.44; <0.00001), neurotoxicity (OR =0.51; 95% CI: 0.36-0.71; = 0.0004); increased immune function (CD3: MD=6.34; 95% CI: 5.52-7.16; < 0.00001, CD4: MD=-5.99; 95% CI: 5.20-6.78; < 0.00001; and CD4/CD8: MD=0.34; 95% CI: 0.14-0.54; < 0.0009), and prolonged survival time (OR =1.77; 95% CI: 1.25-2.50; 0.001). Renal dysfunction caused by chemotherapy was not affected by KAI treatment (Odds Ratio (OR) =0.53; 95%IC: 0.25-1.12; = 0.10).
CONCLUSION
KAI can increase clinical effectiveness, improve quality of life, alleviate ADRs, and prolong survival time in advanced colorectal (CRC) patients receiving chemotherapy.
目的
系统评价常用中药康艾注射液（KAI）能否提高晚期结直肠癌（CRC）患者化疗的临床疗效并减轻化疗不良反应。
方法
截至2019年3月，在三个英文和三个中文电子数据库中进行全面的文献检索。文献由EndNote X8筛选，数据由RevMan5和Stata12.0分析。
结果
该荟萃分析纳入28项研究，共报告2310例病例。其中，1207例接受KAI联合化疗，1103例仅接受化疗。结果显示，KAI联合化疗显著改善肿瘤反应（风险比（RR）=1.32；95%置信区间（CI）：1.22 - 1.43；P<0.00001）；卡氏功能状态（KPS评分）（RR =1.48；95%CI：1.36 - 1.60；P<0.00001）；减少恶心、呕吐（OR =0.31；95%CI：0.24 - 0.41；P<0.00001）、腹泻（OR =0.36；95%CI：0.25 - 0.52；P<0.00001）、白细胞减少（OR =2.97；95%CI：2.27 - 3.88；P<0.00001）、血小板减少（OR =0.53；95%CI：0.38 - 0.74；P<0.0002）、肝功能障碍（OR =0.29；95%CI：0.20 - 0.44；P<0.00001）、神经毒性（OR =0.51；95%CI：0.36 - 0.71；P = 0.0004）等药物不良反应；增强免疫功能（CD3：MD=6.34；95%CI：5.52 - 7.16；P<0.00001，CD4：MD=-5.99；95%CI：5.20 - 6.78；P<0.00001；CD4/CD8：MD=0.34；95%CI：0.14 - 0.54；P<0.0009），并延长生存时间（OR =1.77；95%CI：1.25 - 2.50；P = 0.001）。化疗引起的肾功能障碍不受KAI治疗影响（优势比（OR）=0.53；95%IC：0.25 - 1.12；P = 0.10）。
结论
KAI可提高晚期结直肠癌（CRC）化疗患者的临床疗效、改善生活质量、减轻不良反应并延长生存时间。
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