Zhang Rong-Rong, Shao Ming-Yi, Fu Yu, Zhao Rui-Xia, Wang Jing-Wen, Li Man, Zhao Yun-Xia, Shao Fan-Lei
Henan University of Chinese Medicine Zhengzhou 450046, China.
the First Affiliated Hospital of Henan University of Chinese Medicine, Henan Center for Evidence-based Medicine of Traditional Chinese Medicine Zhengzhou 450000, China.
Zhongguo Zhong Yao Za Zhi. 2021 May;46(9):2333-2343. doi: 10.19540/j.cnki.cjcmm.20200721.501.
Network Meta-analysis was used to evaluate the efficacy and safety of different oral Chinese patent medicines combined with transcatheter arterial chemoembolization(TACE) in the treatment of primary liver cancer. Randomized controlled trials of oral Chinese patent medicines for primary liver cancer were retrieved from CNKI, Wanfang, VIP, SinoMed, PubMed, Cochrane Library and EMbase databases from inception to May 2020. According to the Cochrane recommendation standard, the quality of the included articles was evaluated, and the data were analyzed by RevMan, R software and GeMTC software. A total of 10 kinds of oral Chinese patent medicines and 68 RCTs were included. Network Meta-analysis results showed that: as compared with TACE alone, 10 kinds of oral Chinese patent medicines combined with TACE showed advantages in effective rate, 1-year survival rate, 2-year survival rate, KPS score improvement rate and reduced adverse reaction incidence. In the pairwise comparison of oral Chinese patent medicines, the results showed that Cidan Capsules were superior to Jinlong Capsules and Xihuang Pills in 1-year survival rate. According to the probabi-lity ranking results: Shenyi Capsules and Ganfule were more obvious in improving the effective rate; Cidan Capsules and Shenyi Capsules were more effective in improving the 1-year survival rate; Pingxiao Capsules and Shenyi Capsules had better efficacy in improving 2-year survival rate; Huaier Granules and Shenyi Capsules had better efficacy in improving the quality of life; Huisheng Oral Liquid and Ganfule were more effective in reducing the incidence of adverse reactions(such as nausea, vomiting and leukocytosis). The current evidence showed that oral Chinese patent medicine combined with TACE was superior to TACE alone in efficacy and safety. In terms of the effective rate, 1-year survival rate, 2-year survival rate, KPS score improvement rate and reduced adverse reaction incidence, the optimal treatment measures were Shenyi Capsules, Cidan Capsules, Pingxiao Capsules, Huaier Granules and Huisheng Oral Liquid in turn. However, due to the limitations of the research, the current level of evidence is not high, and clear conclusions and evi-dence strength still need to be further verified and improved by high-quality researches.
采用网状Meta分析评价不同口服中成药联合经动脉化疗栓塞术（TACE）治疗原发性肝癌的有效性和安全性。从建库至2020年5月，检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Cochrane图书馆和EMbase数据库中关于口服中成药治疗原发性肝癌的随机对照试验。按照Cochrane推荐标准对纳入文献质量进行评价，采用RevMan、R软件和GeMTC软件进行数据分析。共纳入10种口服中成药和68项随机对照试验。网状Meta分析结果显示：与单纯TACE相比，10种口服中成药联合TACE在有效率、1年生存率、2年生存率、KPS评分改善率及降低不良反应发生率方面均显示出优势。在口服中成药的两两比较中，结果显示慈丹胶囊在1年生存率方面优于金龙胶囊和西黄丸。根据概率排序结果：参一胶囊和肝复乐在提高有效率方面更明显；慈丹胶囊和参一胶囊在提高1年生存率方面更有效；平消胶囊和参一胶囊在提高2年生存率方面疗效更好；槐耳颗粒和参一胶囊在改善生活质量方面疗效更好；回生口服液和肝复乐在降低不良反应（如恶心、呕吐、白细胞增多）发生率方面更有效。目前证据表明，口服中成药联合TACE在疗效和安全性方面优于单纯TACE。在有效率、1年生存率、2年生存率、KPS评分改善率及降低不良反应发生率方面，最佳治疗措施依次为参一胶囊、慈丹胶囊、平消胶囊、槐耳颗粒和回生口服液。然而，由于研究存在局限性，目前证据水平不高，明确的结论和证据强度仍需高质量研究进一步验证和完善。
