摘要
目的:系统、全面评价中药复方联合化疗治疗Ⅳ期三阴性乳腺癌(triple-negative breast cancer,TNBC的疗效和安全性。方法:计算机检索The Cochrane Library、PubMed、EMBASE、中国生物医学文献数据库、中国知网、中国期刊全文数据库、万方数据库、中文科技期刊数据库,查找有关中药复方联合化疗治疗Ⅳ期TNBC的随机对照试验,检索时限均从建库至2021年10月。按照纳入和排除标准进行文献筛查、资料选取和质量评估,采用RevMan 5.4统计软件进行Meta分析。结果:共纳入22项随机对照试验,共1739例TNBC患者,Meta分析结果显示,中药复方联合化疗组在临床有效率明显优于单纯化疗组(RR=2.03,95%CI=1.65~2.50,P<0.00001),并能显著改善患者的Karnofsky评分(KPS)(RR=1.41,95%CI=1.22~1.62,P<0.00001),同时能明显降低骨髓抑制(RR=0.40,95%CI=0.27~0.58,P<0.00001)、血小板减少(RR=0.36,95%CI=0.21~0.61,P=0.0001)、血红蛋白减少(RR=0.32,95%CI=0.14~0.74,P=0.008)、恶性呕吐(RR=0.40,95%CI=0.28~0.57,P<0.00001)、肝功能损害(RR=0.36,95%CI=0.14~0.92,P=0.03)等化疗毒副作用的发生率。通过中药使用频率的分析,白术、茯苓、黄芪、当归、柴胡、白芍为Ⅳ期TNBC的常用治疗中药。结论:中药复方联合化疗能提高Ⅳ期TNBC的临床疗效,并能减轻患者化疗所致不良反应。基于中药复方多靶点、多通路的复杂机制,结论仍然需要多中心、大样本、高质量的循证医学证据来进一步证实。
ObjectiveTo systematic and comprehensive evaluate the clinical effectiveness and safety of Compound Chinese Medicine(CCM)combined with chemotherapy in the treatment of the stage IV triple-negative breast cancer(TNBC)patients.Methodshe Cochrane Library,PubMed,EMBASE,China Biomedical Literature Database,China National Knowledge Infrastructure(CNKI),China Journal Full-text Database,Wanfang Database and Chinese Science and Technology Journal database were searched for randomized controlled trials(RCTs)of TCM compound combined with chemotherapy in the treatment of stage IV TNBC,The search time limit was from the establishment of the database to October 2021.According to the inclusion and exclusion criteria,literature screening,data selection and quality assessment were performed.RevMan 5.4 statistical software was used for meta-analysis.Results22 articles involving 1739 TNBC patients were selected.The findings reflected that in comparison to using chemotherapy alone,CCM and chemotherapy combination therapy could significantly increase tumor response(RR=2.03,95%CI=1.65~2.50,P<0.00001)and Karnofsky performance scores(KPS)(RR=1.41,95%CI=1.22~1.62,P<0.00001).Besides,as an adjunctive therapy,CCM significantly alleviated the incidence of chemotherapeutic toxicity,including white blood cell(WBC)inhibition(RR=0.40,95%CI=0.27~0.58,P<0.00001),the decrease of platelet(RR=0.36,95%CI=0.21~0.61,P=0.0001),hemoglobin reduction(RR=0.32,95%CI=0.14~0.74,P=0.008),nausea and vomiting(RR=0.40,95%CI=0.28~0.57,P<0.00001),and hepatic function damage(RR=0.36,95%CI=0.14~0.92,P=0.03).Through the analysis of the use frequency of herb medicine,Atractylodes macrocephala,Poria cocos,Astragalus membranaceus,Angelica sinensis,bupleurum and Paeonia Alba are the commonly used for the treatment of stage IV TNBC.ConclusionsCCM could be an adjuvant therapy for TNBC patients who receiving chemotherapy.However,our findings must be handled with care due to the limitations of this research.More scientific and rigorous researches are in need to confirm these results.
作者
毛丹
李玲
胡洋
雷军
冯磊
MAO Dan;LI Ling;HU Yang;LEI Jun;FENG Lei(Department of integrated traditional Chinese and Western internal medicine,The Second Xiangya Hospital of Central South University,Changsha 410007,China;College of traditional Chinese Medicine,Hunan University of Chinese Medicine,Changsha 410011,China;Vascular tumor interventional Department,Hunan Academy of Traditional Chinese Medicine Affliated Hospital,Changsha 410006,China)
出处
《中国民族民间医药》
2022年第20期100-108,共9页
Chinese Journal of Ethnomedicine and Ethnopharmacy
基金
国家自然科学基金青年项目(No.821015346)
湖南省自然科学基金青年项目(No.2020JJ5824)
湖南省中医药管理局面上项目(No.2021225)
湖南省中医药管理局面上项目(No.D2022087)
湖南省中医药研究院院级科研课题(No.202005)。
关键词
中药复方
三阴性乳腺癌
化疗
系统评价
META分析
Compound Chinese Medicine
Triple-Negative Breast Cancer
Chemotherapy
Systematic Review
Meta-Analysis
