摘要
目的:对益气活血法联合化疗治疗中晚期胃癌的国内外相关研究文献进行Meta分析,评价益气活血法辅助治疗中晚期胃癌的疗效与安全性。方法:搜集与益气活血法治疗中晚期胃癌相关的随机对照研究,将纳入的研究按照Cochrane协作网推荐的方法评价其方法学质量,对纳入研究的测量指标通过RevMan 5.3软件进行相关统计学分析。结果:经筛选后共纳入12项研究,合计933例患者。Meta分析结果显示:以益气活血法联合化疗治疗中晚期胃癌在提高有效率(OR=2.31,95%CI为1.72~3.09),Z=5.63,P<0.00001)和总有效率(OR=2.32,95%CI为1.69~3.18,Z=5.20,P<0.00001)、改善患者生命质量(OR=4.17,95%CI为2.75~6.30,Z=6.75,P<0.00001)、减少患者不良反应发生率包括白细胞下降发生率(OR=0.22,95%CI为0.12~0.39,Z=5.17,P<0.00001),恶心发生率(OR=0.45,95%CI为0.29~0.70,Z=3.55,P=0.0004),腹泻发生率(MD=0.32,95%CI为0.20~0.51,Z=3.55,P<0.00001)、改善免疫指标NK(RR=3.83,95%CI为1.50~6.15,Z=3.23,P=0.001)方面具有疗效优势,优于单纯化疗组,差异有统计学意义;但对于改善免疫指标CD4/CD8(D=0.49,95%CI为0.30~0.67,Z=5.16,P<0.00001)无明显优势。结论:以益气活血法联合化疗治疗中晚期胃癌,比单纯化疗更有优势,且不良反应较少。但鉴于文献质量普遍偏低,目前要推荐益气活血法对中晚期胃癌的临床治疗尚欠可靠证据,期待有高质量RCT研究进一步验证及机制的进一步挖掘。
Objective:Meta-analysis of relevant domestic and foreign research literature on the treatment of advanced gastric cancer by the method of supplementing qi and activating blood combined with chemotherapy was carried out to evaluate the efficacy and safety of supplementary therapy of Yiqi Huoxue in the treatment of advanced gastric cancer.Methods:we collected randomized controlled studies related to the treatment of mid-advanced gastric cancer with the method of nourishing qi and activating blood,evaluated the methodological quality of the included studies according to the method recommended by the Cochrane Collaboration,and performed relevant statistical analysis on the measurement indicators of the included studies with RevMan 5.3 software.Results:A total of 12 studies were included and 933 patients were collected after screening.Meta-analysis showed therapeutic advantage of Yiqi Huoxue therapy combined with chemotherapy in the treatment of advanced gastric cancer has curative advantage in improving response rate[OR=2.31,95%CI=(1.72 to 3.09),Z=5.63(P<0.00001)]and overall response rate[OR=2.32,95%CI=(1.69 to 3.18),Z=5.20(P<0.00001)],improving rate of quality of life[OR=4.17,95%CI=(2.75 to 6.30),Z=6.75(P<0.00001)],reducing the incidence of adverse reactions including the incidence of leukocyte decline[OR=0.22,95%CI=(0.12 to 0.39),Z=5.17(P<0.00001)],nausea incidence[OR=0.45,95%CI=(0.29 to 0.70),Z=3.55(P=0.0004)]and diarrhea incidence[MD=0.32,95%CI=(0.20 to 0.51),Z=3.55,(P<0.00001)].In terms of improving immune NK it has the advantage of curative effects(RR=3.83,95%CI=(1.50 to 6.15),Z=3.23(P=0.001)].It was better than chemotherapy alone.The difference was statistically significant.However,there was no significant advantage in improving the immune CD4/CD8[MD=0.49,95%CI=(0.30 to 0.67),Z=5.16(P<0.00001)].Conclusion:Yiqi Huoxue therapy combined with chemotherapy in the treatment of advanced gastric cancer is superior to the latter alone.However,in view of the generally low quality of the literature,at present,there is no reliable evidence to recommend the clinical treatment of the treatment of advanced gastric cancer with the method of replenishing qi and activating blood,and we look forward to further verification of high-quality RCT studies and further exploration of the mechanism.
作者
姜翠红
刘睿
王佳
祁鑫
裴迎霞
赵志正
JIANG Cuihong;LIU Rui;WANG Jia;QI Xin;PEI Yingxia;ZHAO Zhizheng(Department of Oncology,Southern District,Guang′anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 102600,China;Department of Oncology,Guang′anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China)
出处
《世界中医药》
CAS
2021年第8期1250-1257,共8页
World Chinese Medicine
基金
国家自然科学基金项目(81703918)。
关键词
益气活血
气虚血瘀证
中晚期胃癌
中医药
化疗
随机对照试验
META分析
Yiqi Huoxue
Syndrome of qi deficiency with blood stasis
Advanced gastric cancer
Traditional Chinese medicine
Chemotherapy
Randomized controlled trial
Meta-analysis
