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西黄丸/胶囊辅助治疗宫颈癌的疗效与安全性的 Meta 分析。

Meta-analysis of the efficacy and safety of Xihuang Pills/capsules in adjuvant treatment of uterine cervical neoplasms.

机构信息

College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, P.R. China.

Jinan city Hospital of Integrated Traditional Chinese and Western Medicine, Jinan, P.R. China.

出版信息

Medicine (Baltimore). 2023 Aug 25;102(34):e34846. doi: 10.1097/MD.0000000000034846.

Abstract

BACKGROUND

Xihuang Pills/Capsules have a longstanding history of utilization in traditional Chinese medicine (TCM) for treating cancer. Nevertheless, a comprehensive investigation is required regarding the specific impacts and safety of Xihuang Pills/Capsules in individuals with uterine cervical neoplasms. Thus, conducting a meta-analysis is essential to evaluate the clinical effectiveness of combining Xihuang Pills/Capsules with Western medicine in patients with cervical neoplasms.

METHODS

The research involved searching 5 English and 4 Chinese databases for randomized controlled trials (RCTs) investigating the use of Xihuang Pills/Capsules in conjunction with Western medicine for treating uterine cervical neoplasms. Subsequently, statistical analysis was carried out using Review Manager software (version 5.3).

RESULTS

This research encompassed 10 RCTs involving 937 patients. The findings revealed that the combination of Xihuang Pills/Capsules with Western medicine treatment led to improvements in various aspects of the patients' condition. Specifically, there was an enhancement in the short-term efficacy rate (risk ratio [RR] = 1.14, 95% confidence interval [CI]: 1.06-1.22, P = .0003), Karnofsky performance score (KPS) (mean difference [MD] = 5.90, 95% CI: 0.54-11.26, P = .03), survival rates, CD3+, CD3 + CD4+, CD3 + CD8+, CD3-CD56 + cells, and immunoglobulin M in patients with uterine cervical neoplasms. Moreover, the combination treatment resulted in a reduction of adverse reactions, including gastrointestinal reactions (RR = 0.52, 95% CI: 0.42-0.64, P < .00001), radiation proctitis (RR = 0.47, 95% CI: 0.33-0.68, P < .0001), myelosuppression (RR = 0.41, 95% CI: 0.26-0.64, P < .0001), as well as carcinoembryonic antigen (CEA) and squamous cell carcinoma antigen (SCC-Ag) levels. Additionally, the treatment exhibited an inhibitory effect on white blood cells (WBCs) and platelets (PLTs).

CONCLUSION

The amalgamation of Xihuang Pills/Capsules with conventional anti-tumor therapy proves to be both effective and safe in the treatment of cervical neoplasms. However, further validation through high-quality RCTs is necessary to substantiate these findings.

摘要

背景

西黄丸/胶囊在中医药治疗癌症方面有着悠久的历史。然而,需要全面研究西黄丸/胶囊在宫颈癌患者中的具体作用和安全性。因此,进行荟萃分析对于评估西黄丸/胶囊联合西药治疗宫颈癌患者的临床疗效至关重要。

方法

本研究检索了 5 个英文数据库和 4 个中文数据库,纳入了西黄丸/胶囊联合西药治疗宫颈癌的随机对照试验(RCT)。采用 Review Manager 软件(版本 5.3)进行统计学分析。

结果

本研究纳入了 10 项 RCT,共 937 名患者。结果表明,西黄丸/胶囊联合西药治疗可改善患者的病情。具体而言,短期疗效(风险比 [RR] = 1.14,95%置信区间 [CI]:1.06-1.22,P =.0003)、卡氏功能状态评分(KPS)(均数差 [MD] = 5.90,95%CI:0.54-11.26,P =.03)、生存率、CD3+、CD3+CD4+、CD3+CD8+、CD3-CD56+细胞和免疫球蛋白 M 水平均有所提高。此外,联合治疗还降低了不良反应的发生率,包括胃肠道反应(RR = 0.52,95%CI:0.42-0.64,P <.00001)、放射性直肠炎(RR = 0.47,95%CI:0.33-0.68,P <.0001)、骨髓抑制(RR = 0.41,95%CI:0.26-0.64,P <.0001)以及癌胚抗原(CEA)和鳞状细胞癌抗原(SCC-Ag)水平。此外,该治疗方案还对白细胞(WBC)和血小板(PLT)具有抑制作用。

结论

西黄丸/胶囊联合常规抗肿瘤治疗在宫颈癌的治疗中既有效又安全。然而,需要进一步通过高质量的 RCT 来验证这些发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed5e/10470801/7bed74bafa68/medi-102-e34846-g001.jpg

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