健脾中药联合化疗改善大肠癌患者免疫功能的系统评价

The Improvement of Immunity in Colorectal Caner Patients Receiving Jianpi Herbs Combine Chemotherapy:A Systematic Review

目的评价健脾中药联合化疗对大肠癌患者免疫功能的改善作用。方法通过计算机检索中国生物医学文献光盘数据库(CBMdisc)、中国期刊全丈数据库(CJFD)、万方数据医药信息系统(Wangfang Data),收集有关健脾中药联合化疗与单用化疗比较的随机对照研究,并采用 Cochrane 协作网提供的 RevMan4.2.10软件进行 Meta 分析。结果纳入血清 CD_3、CD_4/CD_8、NK 水平的研究分别为5、7、5个。所有入选研究方法学质量评价均为 C 级。与单用化疗比较,健脾中药联合化疗可显著提高大肠癌患者血清 CD_3(SMD=0.53,95%CI:0.33～0.73,P<0.0001)、CD_4/CD_8(SMD=0.50,95%CI:0.33～0.67,P<0.0001)和 NK(sMD=1.29,95%CI:0.95～1.62,P<0.0001)水平。结论目前有关健脾中药联合化疗治疗大肠癌的随机对照研究在方法学应用方面仍有差距。本评价显示健脾中药联合化疗可能改善大肠癌患者的免疫功能,但结论有待高质量的随机对照临床研究进一步证实。

Objective To assess the improvement of immunity in colorectal caeer patients receiving Jianpi herbs combine chemotherapy. Methods The randomized controlled trials （RCTs） comparing Jianpi herbs combine chemotherapy with routine chemotherapy were searched through CBMdisc, CJFD, Wangfang Data by computerized retrieval. RevMan4.2.10, provided by Cochrane library, was used to perform Meta analysis. Results RCTs enrolled to assess the serum CD3, CD4/CD8, NK level were 5, 7, 5, respectively. The methodology quality of all enrolled RCTs was level C. To compare with routine chemotherapy, Jianpi herbs combine chemotherapy significantly increased the serum CD3 （SMD=0.53, 95%Ch 0.33-0.73, P〈0.0001）, CD4/CD8 （SMD=0.50, 95%CI： 0.33-0.67, P〈0.0001） and NK （SMD=1.29, 95%CI： 0.95-1.62, P〈0.0001） level. Conclusion The methodological quality of the RCTs using Jianpi herbs combine chemotherapy on treating colorectal cancer should be improved. Based on this systematic review, Jianpi herbs combine chemotherapy may improve the immunity of colorectal cancer patients. Well-designed RCTs are needed in the future.