中药治疗乳腺癌术后上肢水肿的系统评价

Systematic Review of Postoperative Upper Extremity Edema of Breast Cancer Treatment with Traditional Chinese Medicine

目的系统评价中药方剂治疗乳腺癌术后的上肢水肿的疗效。方法检索CNKI、VIP、CBM和万方数据库,检索时限为1996年1月1日至2016年7月31日,检索策略为中药方剂治疗乳腺癌术后上肢水肿的随机对照试验(RCTs),运用Rev Man 5.3软件进行Meta分析。结果纳入的11篇RCTs显示,中药治疗有更好的疗效〔中药组较物理治疗组OR=4.40,95%CI=(2.82,6.85),P<0.00001〕〔中药组较利尿剂治疗组OR=5.67,95%CI=(3.27,9.82),P<0.00001〕,中药治疗能明显增加水肿患者肢体周径差〔SMD=-2.37,95%CI=(-2.85,-1.89),P<0.00001〕,中药治疗降低水肿患者的上臂周径显著〔SMD=-1.98,95%CI=(-2.34,-1.64),P<0.00001〕。结论中药可降低乳腺癌术后上肢水肿患者上臂周径差,疗效良好。

OBJECTIVE To evaluate efficacy of traditional Chinese medicine in the treatment of postoperative upper extremity edema of breast cancer patients. METHODS Data of randomized controlled trials（ RCTs） were retrieved from CNKI VIP CBM and WANFANG database in patients of postoperative upper extremity edema of breast cancer treated by traditional Chinese medicine. Statistics analysis was performed by Revman 5. 3 software. RESULTS11 RCTs were included in the study. Meta-analysis showed that the edema was relieved by traditional Chinese medicine 〔traditional Chinese medicine vs physical therapy OR = 4. 58,95% CI =（ 2. 95,7. 13）,P〈0. 00001; traditional Chinese medicine vs diuretic therapy OR = 5. 67,95% CI =（ 3. 27,9. 82）,P〈0. 00001 〕. Traditional Chinese medicine treatment significantly increased weeks path difference 〔SMD =-2. 37,95% CI =（-2. 85,-1. 89）,P〈0. 00001 〕and also remarkably reduced arm weeks diameter of edema patients 〔SMD =-1. 98,95% CI =（-2. 34,-1. 64）,P 0. 00001〕. CONCLUSION Traditional Chinese medicine reduces arm weeks＇ radius and has advantages on postoperative upper extremity edema of breast cancer patients.