中医药联合化疗对大肠癌根治术后疗效的系统评价

Systematic evaluation on the curative effect of traditional Chinese medicine combined with chemotherapy for colorectal cancer after radical operation

目的系统评价中医药联合化疗治疗大肠癌根治术后患者的临床效果。方法计算机检索1995年1月~2015年12月中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)、万方科技期刊全文数据库(Web版)、中文科技期刊数据库(VIP)、Pub Med、ISI Web of Knowledge、Cochrane Library医学数据库以及中国重要会议论文全文数据库。根据纳入、排除标准来确定入选文献后,参考Cochrane手册提供的质量评价标准对符合纳入标准的文献进行质量评价,应用Rev Man 5.3软件进行统计分析。结果本研究共纳入文献12篇,结果显示中医药联合化疗可改善大肠癌根治术患者的生活质量(QOL)(RR=1.76,95%CI:1.35~2.30,P<0.0001),提高5年生存率(RR=1.72,95%CI:1.18~2.49,P=0.005),升高CD3^+、CD4^+细胞计数和CD4^+/CD8^+比值(MD=18.95,95%CI:0.09~37.82,P<0.05;MD=5.87,95%CI:2.25~9.49,P=0.00;MD=0.24,95%CI:0.11~0.38,P=0.00),降低胃肠道毒副作用发生率(RR=0.51,95%CI:0.42~0.61,P<0.000 01),增高化疗后白细胞水平(RR=0.51,95%CI:0.31~0.83,P=0.007)。结论中医药联合化疗可提高大肠癌根治术后患者的远期疗效,减轻化疗毒副作用,改善生活质量,提高机体免疫力。

Objective To evaluate the clinieal effect of traditional Chinese medicine combined with chemotherapy in the treatment of patients with colorectal cancer after radical resection. Methods Computer was used to search various domestic and foreign medical journals published from January 1995 to January 2015, including China biomedical literature database （CBM）, China national knowledge infrastructure （CNKI）, Wanfang database, China scientific journal database （VIP）, PubMed, ISI Web of Knowledge, Cochrane Library and important Chinese conference paper full-text database. The quality of the selected literature was determined according to the inclusion and exclusion criteria. The quality evaluation standard provided by the Cochrane manual was referenced for quality evaluation with inclusion criteria. RevMan 5.3 software was conducted for statistical analysis. Results A total of 12 articles were included in this study. The results showed that the application of traditional Chinese medicine combined with chemotherapy could improve the quality of life （QOL） （RR = 1.76, 95%CI： 1.35-2.30, P 〈 0.0001）, increase the 5-year survival rate （RR = 1.72, 95%CI： 1.18-2.49, P = 0.005）; raise CD3^＋, CD4^＋ cell count, CD4^＋/CD8^＋ ratio （MD = 18.95, 95%CI： 0.09-37.82, P 〈 0.05; MD = 5.87,95%CI： 2.25-9.49, P = 0.00; MD = 0.24, 95%CI： 0.11-0.38, P = 0.00）, decrease the incidence of gastrointestinal reactions（RR = 0.51, 95%CI：0.42-0.61, P 〈 0.000 01）, heighten the leukocyte levels （RR = 0.51, 95%CI： 0.31-0.83, P = 0.007）. Conclusion Traditional Chinese medicine combined with chemotherapy can improve the long-term curative effect of radical resection of colorectal cancer, reduce the side effects of chemotherapy, improve the quality of life and promote the immunity of the patients.