Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Eur Rev Med Pharmacol Sci. 2023 Apr;27(7):3053-3062. doi: 10.26355/eurrev_202304_31939.
The treatment of targeted therapy-induced diarrhea, a common adverse reaction of targeted therapy, with traditional Chinese medicine (TCM) has unique advantages; however, a unified TCM prescription is currently missing in clinical practice, and objective outcome indicators are lacking. Here, we aimed to provide medical evidence for the use of oral TCM in the treatment of targeted therapy-induced diarrhea. To this end, we systematically reviewed the literature evaluating the clinical efficacy of oral TCM for the treatment of targeted therapy-induced diarrhea.
The Chinese National Knowledge Infrastructure, China Biology Medicine disc, Technology Journal Database, Wanfang Medical Network, PubMed, Cochrane Library, EMBASE, MEDLINE, and OVID databases were used for a literature search of clinical randomized controlled trials examining the use of oral TCM in the treatment of targeted therapy-induced diarrhea until February 2022. A meta-analysis was performed using RevMan 5.3 software.
In total, 490 relevant studies were screened, 480 were excluded based on the inclusion and exclusion criteria, and 10 clinical studies were finally included. The 10 studies included a total of 555 patients: 279 in the treatment group and 276 in the control group. The improvements in total clinical efficiency, TCM syndrome score, and graded efficacy of diarrhea in the treatment group were better than those in the control group (p<0.01); however, there was no difference in the Karnofsky Performance Scale score between the groups. The funnel plot for total clinical efficiency was symmetrical, and the publication bias was found to be low.
Oral TCM is an effective treatment for targeted therapy-induced diarrhea and can significantly improve the clinical symptoms and quality of life of patients.
靶向治疗相关腹泻是靶向治疗的常见不良反应，采用中医药治疗具有独特优势；但目前临床缺乏统一的中医药处方，缺乏客观的疗效指标。本研究旨在为口服中药治疗靶向治疗相关性腹泻提供循证医学证据。为此，我们系统地检索了评估口服中药治疗靶向治疗相关性腹泻的临床疗效的文献。
中文数据库（中国知网、中国生物医学文献数据库、维普数据库）、英文数据库（PubMed、Cochrane Library、EMBASE、MEDLINE、OVID）检索时间截至 2022 年 2 月，检索口服中药治疗靶向治疗相关性腹泻的临床随机对照试验，采用 RevMan 5.3 软件进行 meta 分析。
共筛选出 490 篇相关文献，根据纳入和排除标准排除 480 篇，最终纳入 10 项临床研究，共 555 例患者，治疗组 279 例，对照组 276 例。治疗组总有效率、中医证候积分、腹泻分级疗效改善均优于对照组（p<0.01），但两组卡氏功能状态评分比较差异无统计学意义。总有效率漏斗图基本对称，发表偏倚较小。
口服中药是治疗靶向治疗相关性腹泻的有效方法，能明显改善患者的临床症状和生活质量。
