Lu Xiaona, Zheng Yawei, Wen Fang, Huang Wenjie, Shu Peng
First School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing 210029, China.
Oncology Department, Jiangsu Province Hospital of Chinese Medicine, Nanjing 210029, China.
Evid Based Complement Alternat Med. 2020 Aug 26;2020:8016531. doi: 10.1155/2020/8016531. eCollection 2020.
This network meta-analysis (NMA) was designed to assess the comparative effectiveness and safety of oral Chinese patent medicines combined with chemotherapy for gastric cancer on the National Basic Medical Insurance Drugs List of China.
A comprehensive literature search was performed in seven electronic databases from their inception to February 25, 2020, aiming to collect all related randomized controlled trials (RCTs) to evaluate the effectiveness and safety of oral Chinese patent medicines as an adjuvant for gastric cancer. Two researchers independently screened the literature, extracted data, and assessed the risk of bias of included studies using the Cochrane Risk of Bias Scale. NMA was then performed by using STATA 16.0 software and ADDIS 1.16.8 software.
Finally, 30 RCTs were included, involving seven kinds of oral Chinese patent medicines, with a total of 2602 patients. For improvement of clinical efficacy, Bazhen granule combined with chemotherapy was ranked first for effectiveness, followed by the Cinobufacin capsule combined with chemotherapy and Xiao'aiping tablet combined with chemotherapy. Meanwhile, Bazhen granules combined with chemotherapy also were ranked first in reducing gastrointestinal reactions. In terms of improving performance status, the Xiao'aiping tablet was the best and significantly better than other oral Chinese patent medicines. Besides, the Zhenqi Fuzheng granule combined with chemotherapy was best for reducing the incidence of leucopenia.
Since only one RCT of Bazhen granule was included in this study for analysis, its statistical efficiency is low. Therefore, this study recommends that the Cinobufacin capsule combined with chemotherapy should be a priority in improving clinical efficacy. In terms of improving patients' quality of life, Xiao'aiping tablet is the best choice. Safety was best for Zhenqi Fuzheng granule and Bazhen granule combined with chemotherapy. Limited by the quantity, quality, and possible bias of included studies, the above conclusions need to be further verified by more high-quality RCTs.
本网络荟萃分析（NMA）旨在评估中国国家基本医疗保险药品目录中口服中成药联合化疗治疗胃癌的相对有效性和安全性。
对7个电子数据库从建库至2020年2月25日进行全面文献检索，旨在收集所有相关随机对照试验（RCT），以评估口服中成药作为胃癌辅助治疗的有效性和安全性。两名研究人员独立筛选文献、提取数据，并使用Cochrane偏倚风险量表评估纳入研究的偏倚风险。然后使用STATA 16.0软件和ADDIS 1.16.8软件进行NMA。
最终纳入30项RCT，涉及7种口服中成药，共2602例患者。在提高临床疗效方面，八珍颗粒联合化疗有效性排名第一，其次是华蟾素胶囊联合化疗和消癌平片联合化疗。同时，八珍颗粒联合化疗在减轻胃肠道反应方面也排名第一。在改善体能状态方面，消癌平片最佳，且显著优于其他口服中成药。此外，贞芪扶正颗粒联合化疗在降低白细胞减少发生率方面效果最佳。
由于本研究仅纳入1项八珍颗粒的RCT进行分析，其统计效能较低。因此，本研究建议华蟾素胶囊联合化疗在提高临床疗效方面应作为首选。在改善患者生活质量方面，消癌平片是最佳选择。贞芪扶正颗粒和八珍颗粒联合化疗的安全性最佳。受纳入研究的数量、质量及可能存在的偏倚限制，上述结论需更多高质量RCT进一步验证。
