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中药注射剂对癌因性疲乏的影响:基于现有证据的Meta分析

Effect of Traditional Chinese Medicine Injection on Cancer-Related Fatigue: A Meta-Analysis Based on Existing Evidence.

作者信息

Huang Zhengkai, Zhang Qiang, Fan Yihua, Zhou Jiajing, Liang Mingkun, Deng Xin, Liang Jian

机构信息

College of Integrated Traditional Chinese and Western Medicine, Hunan University of Chinese Medicine, Changsha 410208, China.

Department of Oncology, Army Medical Center of PLA, ChongQing 400042, China.

出版信息

Evid Based Complement Alternat Med. 2020 Dec 21;2020:2456873. doi: 10.1155/2020/2456873. eCollection 2020.

Abstract

METHODS

We systematically searched randomized controlled studies reported through March 2020 in PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, Web of Science, China Biomedical Literature Database (CBM), the China National Knowledge Infrastructure (CNKI), Wanfang, and VIP databases. Two investigators independently screened the studies according to the predetermined criteria, extracted data, and evaluated the bias risk of the included studies, using RevMan5.3 software.

RESULTS

Twelve studies enrolling 1005 participants were included in this systematic review. We found that TCMJ could improve the clinical efficacy of CRF patients (RR = 1.24, 95% CI: 1.05-1.46, =0.01), ameliorate fatigue status (RR = 1.44, 95% CI: 1.27-1.65, < 0.00001), and improve quality of life (MD = 8.34, 95% CI: 3.31-13.37, =0.001), but there was no statistical significance in the fatigue score (MD = -1.10, 95% CI: -2.23-0.04, =0.06). Referring to the number of adverse events, the safety of TCMJ was good. Subgroup analysis showed that TCMJ could improve clinical efficacy, fatigue, and quality of life in a short time (≤4 weeks). Among them, tonic TCMJ could improve the clinical efficacy. TCMJ had advantages in improving fatigue of lung cancer and gastric cancer. In addition, life quality of lung cancer patients improved significantly.

CONCLUSION

Current research evidence showed that TCMJ could improve the clinical efficacy, fatigue status, and life quality of patients with CRF. In addition, we found that TCMJ could improve the clinical efficacy of CRF patients in a short period of time. Tonic TCMJ could improve the clinical efficacy, but heat-clearing TCMJ could not. Life quality and fatigue status of lung cancer patients improved significantly. However, due to the sample size and quality of the included studies, the results of this analysis should be treated with caution. The above conclusions still need to be verified by more large-sample and high-quality randomized controlled trials.

摘要

方法

我们系统检索了截至2020年3月在PubMed、EMBASE、Cochrane对照试验中央注册库、Web of Science、中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方和维普数据库中报道的随机对照研究。两名研究者根据预定标准独立筛选研究、提取数据,并使用RevMan5.3软件评估纳入研究的偏倚风险。

结果

本系统评价纳入了12项研究,共1005名参与者。我们发现,中药煎剂可提高慢性肾衰竭(CRF)患者的临床疗效(RR = 1.24,95%CI:1.05 - 1.46,P = 0.01),改善疲劳状态(RR = 1.44,95%CI:1.27 - 1.65,P < 0.00001),并提高生活质量(MD = 8.34,95%CI:3.31 - 13.37,P = 0.001),但在疲劳评分方面无统计学意义(MD = -1.10,95%CI:-2.23 - 0.04,P = 0.06)。就不良事件数量而言,中药煎剂的安全性良好。亚组分析表明,中药煎剂可在短时间内(≤4周)提高临床疗效、改善疲劳和提高生活质量。其中,滋补类中药煎剂可提高临床疗效。中药煎剂在改善肺癌和胃癌患者的疲劳方面具有优势。此外,肺癌患者的生活质量有显著改善。

结论

当前研究证据表明,中药煎剂可提高CRF患者的临床疗效、改善疲劳状态和生活质量。此外,我们发现中药煎剂可在短时间内提高CRF患者的临床疗效。滋补类中药煎剂可提高临床疗效,而清热类中药煎剂则不能。肺癌患者的生活质量和疲劳状态有显著改善。然而,由于纳入研究的样本量和质量,本分析结果应谨慎对待。上述结论仍需更多大样本、高质量的随机对照试验予以验证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50af/7774033/90c112f08c72/ECAM2020-2456873.001.jpg

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