Department of Gastroenterology, Lingshui County Hospital of Traditional Chinese Medicine, Lingshui, 572400 Hainan, China.
Internal Medicine, Dongfang People's Hospital, Dongfang, 572600 Hainan, China.
Comput Math Methods Med. 2022 Aug 4;2022:8497084. doi: 10.1155/2022/8497084. eCollection 2022.
Meta-analysis was conducted to explore the effects of CM combined with chemotherapy on the effective rate and survival rate of gastric cancer patients.
Literature retrieval was performed in PubMed, MEDLINE, Embase, CENTRAL, and CNKI databases. The subject of the literature was to compare the efficacy of CM combined with chemotherapy and chemotherapy alone in patients with gastric cancer. According to the Cochrane manual, the risk of bias was assessed for inclusion in randomized controlled trials. The chi-square test was used for the heterogeneity test. Subgroup analysis and sensitivity analysis were used to explore the causes of heterogeneity. Funnel chart and Egger's test were used to assess publication bias.
This study included 761 patients with gastric cancer from 10 literatures. The effective rate of chemotherapy in the CM combined group was higher than that in the chemotherapy alone group (odds ratio (OR) = 1.96, 95% confidence interval (CI) (1.39, 2.78), = 3.81, = 0.0001), and there was no heterogeneity among studies (chi = 5.68, = 0.68, = 0%). There was no significant publication bias among all studies ( > 0.05). The one-year survival rate in the CM combined group was higher than that in the chemotherapy alone group (OR = 3.25, 95% CI (1.90, 5.54), = 4.32, < 0.0001). There was no heterogeneity among studies (chi = 1.04, = 0.79, = 0%) and no significant publication bias among studies ( > 0.05). The 3-year survival rate of gastric cancer patients in the traditional Chinese medicine combination group was higher than that in the chemotherapy alone group (OR = 1.71, 95% CI (1.06, 2.78), = 2.18, = 0.03). There was no heterogeneity among studies (chi = 2.18, = 0.54, = 0%), and there was no significant publication bias ( > 0.05). The incidence of nausea and vomiting after chemotherapy in gastric cancer patients in the Chinese medicine combination group was lower than that in the chemotherapy alone group (OR = 0.47, 95% CI (0.34, 0.64), = 4.80, < 0.00001). There was no heterogeneity among studies (chi = 8.57, = 0.48, = 0%), and there was no significant publication bias ( > 0.05).
CM combined with chemotherapy can improve the effective rate and survival rate of gastric cancer and reduce the incidence of nausea and vomiting after chemotherapy. We recommend a large sample size, multicenter combined randomized controlled trial for validation.
系统评价荟萃分析探讨 CM 联合化疗治疗胃癌的有效率和生存率。
检索 PubMed、MEDLINE、Embase、CENTRAL 和中国知网（CNKI）数据库中比较 CM 联合化疗与单纯化疗治疗胃癌患者疗效的文献。根据 Cochrane 手册评估纳入的随机对照试验的偏倚风险。采用卡方检验进行异质性检验。采用亚组分析和敏感性分析探讨异质性的原因。采用漏斗图和 Egger 检验评估发表偏倚。
本研究纳入了 10 项研究的 761 例胃癌患者。CM 联合组化疗的有效率高于单纯化疗组（比值比（OR）=1.96，95%置信区间（CI）（1.39，2.78）， = 3.81， = 0.0001），且研究间无异质性（chi = 5.68， = 0.68， = 0%）。所有研究均无显著发表偏倚（ > 0.05）。CM 联合组的 1 年生存率高于单纯化疗组（OR = 3.25，95%CI（1.90，5.54）， = 4.32， < 0.0001）。研究间无异质性（chi = 1.04， = 0.79， = 0%），且无显著发表偏倚（ > 0.05）。CM 联合组的胃癌患者 3 年生存率高于单纯化疗组（OR = 1.71，95%CI（1.06，2.78）， = 2.18， = 0.03）。研究间无异质性（chi = 2.18， = 0.54， = 0%），且无显著发表偏倚（ > 0.05）。CM 联合组化疗后恶心呕吐的发生率低于单纯化疗组（OR = 0.47，95%CI（0.34，0.64）， = 4.80， < 0.00001）。研究间无异质性（chi = 8.57， = 0.48， = 0%），且无显著发表偏倚（ > 0.05）。
CM 联合化疗可提高胃癌的有效率和生存率，降低化疗后恶心呕吐的发生率。建议开展大样本、多中心联合随机对照试验进行验证。
