健脾方联合化疗治疗晚期大肠癌患者近期疗效及生存质量的Meta分析

Meta Analysis of the Short-term Efficacy and Life Quality of Spleen-invigorating Formula Combined with Chemotherapy for Colorectal Cancer of Late Stage

为比较健脾方药联合化疗与单纯化疗治疗晚期大肠癌在近期疗效和生存质量方面的效果，检索中国生物医学文献数据库（CBM）、中国期刊全文数据库（CNKI）、中国科技期刊全文数据库（VIP）、万方数据医药信息系统（WanfangData），收集2000年1月至2014年5月应用健脾方药联合化疗与单用化疗治疗晚期大肠癌的比较随机对照研究资料，采用Cochrane协作网提供的RevMan4．2．10软件进行Meta分析。结果显示，入选的8项随机对照试验（RcT）研究方法学质量评价均为C级。纳人肿瘤缓解率、1年生存率、生存质量的研究分别为7、3、5个。与单用化疗相比，健脾方药联合化疗可提高患者肿瘤缓解率（OR—1．57，95％CI：1．03—2．40，P=0004〈0．05），显著提高患者生存质量（OR=2．90，95％CI：1．69—4．99，P=0．0001〈0．01）。但在1年生存率方面比较差异无统计学意义（P=0．08〉O．05）。结果表明，健脾方药联合化疗在治疗晚期大肠癌患者有效率上稍好于单纯化疗，在提高患者生存质量上有较显著的优势，但在提高1年生存率上基本无优势，该结论还有待高质量的RCT进一步证实。

For compare the short-term efficacy and life quality of combined with chemotherapy spleen-invigorating formula alone chemotherapy in treating colorectal cancer of late stage,data on randomized controlled trial were retrieved from CBM, CNKI, VIP and Wanfang data medicine information system, from January 2000 to May 2014. Software RevMan 4.2.10, provided by Cochrane Library, was used to perform meta analysis. The results showed that the methodology adopted in the enrolled eight RCT（randomized controlled trial） was all evaluated as grade C.Tumor response rate was included in 7 studies, 1-year survival study in 3 studies and quality of life in 5 studies.Chemotherapy combined with spleen-invigorating formula can improve tumor response rate, and significantly improve the quality of life （OR = 1.57,95 % CI： 1.03- 2.40, P = 0.04%0.05）, （OR=2.90,95%CI： 1.69-4.99, P =0.0001%0.01）,but showed no significant difference in 1-year survival（ P =0.08〉0.05）.It is concluded that chemotherapy combined with spleen-invigorating formula is bit better effective and shows more advantages in improving the quality of life, but one year survival rate basically had no advantage. The using spleen-invigorating formula combined with chemotherapy in treating colorectal cancer should be confirmed by further RCT of high quality.