Zhang Dong, Ni Ming-Xin, Wei Xiao-Man, Geng Xue-Chen, Li Liu, Cheng Hai-Bo
the First Clinical Medical College, Nanjing University of Chinese Medicine Nanjing 210023, China Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing 210029, China Jiangsu Collaborative Innovation Center of Traditional Chinese Medicine in Prevention and Treatment of Tumor Nanjing 210023, China.
Zhongguo Zhong Yao Za Zhi. 2024 Dec;49(23):6512-6520. doi: 10.19540/j.cnki.cjcmm.20240812.501.
This study systematically reviewed the literature on the prevention and treatment of colorectal cancer(CRC) with traditional Chinese medicine(TCM), aiming to present a more intuitive and concise overview of existing evidence. Four major Chinese databases, including CNKI, Wanfang, VIP, and SinoMed, were searched for randomized controlled trial(RCT) on TCM treatment of CRC. The retrieval period was from database inception to August 1, 2023. The evidence was presented using a combination of text and charts. A total of 1 778 RCTs were included, and the overall publication volume showed an upward trend. The quality of the RCT was generally low, with sample sizes concentrated between 60 and 100 cases. The intervention durations were mainly 4, 8, and 12 weeks. Keywords primarily focused on advanced CRC, postoperative CRC, immune function, and gastrointestinal function. Clinical complications were often caused by surgery or chemotherapy, including intestinal obstruction, peripheral neuropathy, diarrhea, and anxiety and depression. There were various intervention measures, including TCM decoctions, TCM injections, Chinese medicine nursing, Chinese patent medicines, and acupuncture. Among them, TCM decoctions(excluding self-made prescriptions) included Shenling Baizhu Powder(32 articles, 1.80%) and Sijunzi Decoction(22 articles, 1.24%). TCM injections included Fufang Kushen Injection(54 articles, 3.04%) and Aidi Injection(46 articles, 2.59%). Chinese patent medicines included Cinobufacin Capsules(16 articles, 0.90%) and Fufang Banmao Capsules(10 articles, 0.56%). The outcome indicators were divided into 13 domains, including recent efficacy, quality of life, safety events, and TCM syndrome/symptom scores. The existing outcome indicators mostly followed the western medicine evaluation system, with complex types and no unified standards, lacking outcome indicators or scales with TCM characteristics, and relatively insufficient attention to long-term efficacy, anxiety, and depression. Future research should optimize clinical study designs, build a core index set and clinical evaluation system with TCM characteristics, and produce more high-level evidence to support the safety and effectiveness of TCM in preventing and treating CRC.
本研究系统回顾了中医药防治结直肠癌(CRC)的相关文献,旨在更直观、简洁地呈现现有证据。检索了包括中国知网、万方、维普和中国生物医学文献数据库在内的四个主要中文数据库,以查找中医药治疗CRC的随机对照试验(RCT)。检索期为各数据库建库至2023年8月1日。证据以文字和图表相结合的形式呈现。共纳入1778项RCT,总体发表量呈上升趋势。RCT的质量普遍较低,样本量集中在60至100例之间。干预持续时间主要为4周、8周和12周。关键词主要集中在晚期CRC、CRC术后、免疫功能和胃肠功能。临床并发症常由手术或化疗引起,包括肠梗阻、周围神经病变、腹泻以及焦虑和抑郁。干预措施多种多样,包括中药汤剂、中药注射剂、中医护理、中成药和针灸。其中,中药汤剂(不包括自拟方)包括参苓白术散(32篇,1.80%)和四君子汤(22篇,1.24%)。中药注射剂包括复方苦参注射液(54篇,3.04%)和艾迪注射液(46篇,2.59%)。中成药包括华蟾素胶囊(16篇,0.90%)和复方斑蝥胶囊(10篇,0.56%)。结局指标分为13个领域,包括近期疗效、生活质量、安全事件和中医证候/症状评分。现有的结局指标大多遵循西医评价体系,类型复杂且无统一标准,缺乏具有中医特色的结局指标或量表,对长期疗效、焦虑和抑郁的关注相对不足。未来研究应优化临床研究设计,构建具有中医特色的核心指标集和临床评价体系,产出更多高水平证据以支持中医药防治CRC的安全性和有效性。