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中医在肝癌切除术后治疗中的应用:疗效的荟萃分析

Traditional Chinese Medicine in post-resection liver cancer therapy: a meta-analysis of efficacy.

作者信息

Wang Jiasong, Wang Yanli, Song Ci, Dong Shiqiu, Yu Qinming

机构信息

School of Basic Medicine, Heilongjiang University of Chinese Medicine Harbin 150000, Heilongjiang, China.

Department of Pharmacy, Heilongjiang Nursing College Harbin 150088, Heilongjiang, China.

出版信息

Am J Transl Res. 2024 Oct 15;16(10):5763-5775. doi: 10.62347/BWOA5995. eCollection 2024.

Abstract

OBJECTIVE

To systematically evaluate the efficacy of traditional Chinese medicine (TCM) in the comprehensive post-resection treatment of primary liver cancer.

METHODS

Clinical studies on TCM in the comprehensive treatment of primary liver cancer post-resection were retrieved from PubMed, Embase, Cochrane and Google Scholar databases. The search encompassed the period from the inception of each database up to June 28, 2024. Two independent reviewers conducted literature screening based on pre-established inclusion and exclusion criteria, performed data extraction, and evaluated the risk of bias and the methodological quality of the included studies. A meta-analysis was conducted utilizing Review Manager 5.3 software.

RESULTS

A total of 12 studies involving 19,116 patients were included in this study. The meta-analysis revealed that TCM treatment following liver cancer resection significantly reduced the recurrence rate, mortality and incidence of adverse events (RR = 0.76, 95% CI 0.70-0.83, < 0.00001; RR = 0.79, 95% CI 0.71-0.88, < 0.0001; RR = 0.71, 95% CI 0.57-0.89, = 0.003). Additionally, TCM notably increased the 1-, 3-, and 5-year overall survival rate (RR = 1.08, 95% CI 1.05-1.11, < 0.00001; RR = 1.19, 95% CI 1.14-1.23, < 0.00001; RR = 1.26, 95% CI 1.12-1.42, < 0.0001), and extended the recurrence-free survival time and the 5-year overall survival time (HR = 0.72, 95% CI 0.65-0.81, < 0.00001; HR = 0.73, 95% CI 0.61-0.87, = 0.0004) in patients with primary liver cancer after resection.

CONCLUSION

TCM has a beneficial impact on the comprehensive treatment of primary liver cancer post-resection. However, further validation through higher-quality clinical studies is warranted.

摘要

目的

系统评价中医药在原发性肝癌切除术后综合治疗中的疗效。

方法

从PubMed、Embase、Cochrane和谷歌学术数据库中检索关于中医药在原发性肝癌切除术后综合治疗的临床研究。检索涵盖各数据库建库至2024年6月28日的时间段。两名独立评审员根据预先设定的纳入和排除标准进行文献筛选,进行数据提取,并评估纳入研究的偏倚风险和方法学质量。使用Review Manager 5.3软件进行荟萃分析。

结果

本研究共纳入12项研究,涉及19116例患者。荟萃分析显示,肝癌切除术后的中医药治疗显著降低了复发率、死亡率和不良事件发生率(RR = 0.76,95%CI 0.70 - 0.83,P < 0.00001;RR = 0.79,95%CI 0.71 - 0.88,P < 0.0001;RR = 0.71,95%CI 0.57 - 0.89,P = 0.003)。此外,中医药显著提高了1年、3年和5年总生存率(RR = 1.08,95%CI 1.05 - 1.11,P < 0.00001;RR = 1.19,95%CI 1.14 - 1.23,P < 0.00001;RR = 1.26,95%CI 1.12 - 1.42,P < 0.0001),并延长了原发性肝癌切除术后患者的无复发生存时间和5年总生存时间(HR = 0.72,95%CI 0.65 - 0.81,P < 0.00001;HR = 0.73,95%CI 0.61 - 0.87,P = 0.0004)。

结论

中医药对原发性肝癌切除术后的综合治疗有有益影响。然而,有必要通过更高质量的临床研究进行进一步验证。

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