摘要
目的系统评价中医外治法防治化疗相关性腹泻(CID)的有效性和安全性,为临床治疗提供循证依据。方法计算机检索Cochrane Library、PubMed、Embase、CNKI、万方、维普数据库2012年1月1日至2022年12月31日关于中医外治法防治CID的随机对照试验。使用NoteExpress软件管理文献,选用Cochrane手册5.4.0推荐的RCT偏倚风险评估方法进行文献质量评价,使用RevMan5.4.1软件进行Meta分析和敏感性分析。结果共纳入24项研究,偏倚风险等级均为B级。Meta分析显示,中医外治组CID治疗有效率高于对照组(RR 1.40,95%CI 1.31~1.51,P<0.00001)。中医外治组CID发生率低于对照组(RR 0.50,95%CI 0.39~0.64,P<0.00001)。敏感性分析结果均显示Meta分析结果稳定。中医外治组和对照组1级、2级、木3级CID发生率对比无差异(1级RR 0.89,95%CI 0.63~1.25,P=0.50;2级RR 0.77,95%CI 0.48~1.24,P=0.28;3级RR 0.84,95%CI 0.39~1.82,P=0.66);中医外治组4级CID发生率低于对照组(RR 0.36,95%CI 0.14~0.93,P=0.03);中医外治组和对照组对CID整体发生程度的影响对比无差异(RR 0.78,95%CI 0.61~1.01,P=0.37)。中医外治组的卡氏(KPS)功能状态评分高于对照组(RR 5.65,95%CI 1.61~9.68,P=0.006)。中医外治组的Karnofsky评分稳定率高于对照组(RR 2.51,95%CI 1.09~5.75,P=0.03)。结论中医外治法可有效防治CID的发生。
Objective To systematically evaluate the effectiveness and safety of external treatment of traditional Chinese medicine in preventing and treating chemotherapy-induced diarrhea(CID),and provide evidence-based basis for clinical treatment.Methods Computerized searches of Cochrane Library,PubMed,Embase,CNKI,Wanfang,and Wipu databases from January 1,2012 to December 31,2022 for randomized controlled trials on external Chinese medicine treatments for the prevention and treatment of CID were performed.NoteExpress software was used to manage the literature,the RCT risk of bias assessment method recommended by the Cochrane Handbook 5.4.0 was selected for literature quality evaluation,and Meta-analysis and sensitivity analysis were performed using RevMan 5.4.1 software.Results A total of 24 studies were included,and the risk of bias grades were all B.Meta-analysis showed that the efficacy rate of external Chinese medicine treatment for CID was higher than that of the control group(RR 1.40,95%CI 1.31-1.51,P<0.00001).The effective rate of preventing CID in the external TCM treatment group was higher than that in the control group(RR 0.50,95%CI 0.39-0.64,P<0.00001).The results of sensitivity analysis all showed stable results of Meta-analysis.There was no difference in the comparison of the effects of the external Chinese medicine treatment group and the control group on the degree of grade 1,2,and 3 CID occurrence in grade 1(RR 0.89,95%CI 0.63-1.25,P=0.50),grade 2(RR 0.77,95%CI 0.48-1.24,P=0.28),and grade 3(RR 0.84,95%CI 0.39-1.82,P=0.66);the effect of the TCM external treatment group on the degree of grade 4 CID occurrence was better than that of the control group(RR 0.36,95%CI 0.14-0.93,P=0.03);there was no difference in the comparison of the effect of the TCM external treatment group and the control group on the overall degree of CID occurrence(RR 0.78,95%CI 0.61-1.01,P=0.37).The Karnof's(KPS)functional status score was higher in the TCM external treatment group than in the control group(RR 5.65,95%CI 1.61-9.68,P=0.006).The stabilization rate of Karnofsky score was higher in the external Chinese medicine treatment group than in the control group(RR 2.51,95%CI 1.09-5.75,P=0.03).Conclusions External treatment of traditional Chinese medicine can effectively prevent and treat the occurrence of CID.
作者
王凤娟
赖春秀
侯丽娜
林晓忆
张佳玉
WANG Fengjuan;LAI Chunxiu;HOU Lina;LIN Xiaoyi;ZHANG Jiayu(Department of Geriatrics,First Affiliated Hospital of Xiamen University,Xiamen 361003,China;Department of Breast surgery,First Affiliated Hospital of Xiamen University,Xiamen 361003,China;Fujian University of Traditional Chinese Medicine,Xiamen 361003,China)
出处
《中国医药指南》
2024年第1期1-6,共6页
Guide of China Medicine
基金
福建中医药大学校管课题(XB2022189)。
关键词
中医外治法
化疗相关性腹泻
随机对照试验
META分析
External treatment of traditional Chinese medicine
Chemotherapy-induced diarrhea
Randomized controlled trial
Meta-analysis
