以黄芪联合当归为主的中药复方治疗肿瘤患者化疗后骨髓抑制效果的系统评价

Systematic review of treatment effect of the traditional Chinese medicine compound based on astragalus and angelica on bone marrow suppression after chemotherapy

目的系统评价以黄芪联合当归为主的中药复方治疗肿瘤患者化疗后骨髓抑制的效果。方法计算机检索Cochrane Library、PubMed、Web of Science、CINAHL、OVID、中国生物医学文献服务系统、CNKI、维普、万方数据库,搜索关于以黄芪联合当归为主的中药复方治疗恶性肿瘤化疗后骨髓抑制疗效的RCT,检索时限从建库至2019年9月。由2名研究员独立筛选文献、提取资料,釆用RevMan 5.3软件进行Meta分析。结果最终纳入15项RCT研究,共1019例患者。Meta分析结果显示:与单纯化疗组或化疗联合西药组相比,以黄芪联合当归为主的中药复方组在改善外周血白细胞[标准化均数差(SMD)=1.32,95%置信区间(CI)为0.76~1.89,P<0.00001]、血小板[加权均数差(MD)=25.05,95%CI(8.00,42.10),P=0.004]、血红蛋白[MD=24.14,95%CI(16.34,31.94),P<0.00001]和临床症状[相对危险度为1.38,95%CI(1.25,1.52),P<0.00001]方面差异有统计学意义。结论以黄芪联合当归为主的中药复方能够改善肿瘤患者化疗后外周血细胞水平,减轻骨髓抑制,同时改善临床症状,提高患者生活质量。但由于纳入文献质量不高,且部分结果存在较大异质性,因此尚需更多严格设计的高质量RCT进一步验证。

Objective To systematically review the effects of the traditional Chinese medicine compound based on astragalus and angelica on bone marrow suppression after chemotherapy.Methods Randomized controlled trials(RCTs)about the traditional Chinese medicine compound based on astragalus and angelica for bone marrow suppression after chemotherapy for malignant tumors were retrieved from Cochrane Library,PubMed,Web of Science,CINAHL,OVID,SinoMed,CNKI,VIP,and Wanfang Databases.The search period was from the establishment of the database to September 2019.The literatures were screened and the data were extracted independently by two researchers and RevMan 5.3 was used for Meta-analysis.Results Totally 15 RCTs were included,involving 1019 patients.Meta-analysis results showed that there were statistically significant differences in peripheral blood leukocytes[SMD=1.32;95%CI(0.76,1.89);P<0.00001],platelets[MD=25.05;95%CI(8.00,42.10);P=0.004],hemoglobin[MD=24.14;95%CI(16.34,31.94);P<0.00001]and clinical symptoms[RR=1.38;95%CI(1.25,1.52);P<0.00001]between the chemotherapy group,the chemotherapy combined with the western medicine group and the traditional Chinese medicine compound group.Conclusions The traditional Chinese medicine compound based on astragalus and angelica can improve the level of peripheral blood cells,reduce bone marrow suppression,and improve clinical symptoms and quality of life of patients with cancer after chemotherapy.However,due to the low quality of the included literature and the large heterogeneity of some of the results,more rigorously designed high-quality RCTs are needed for further verification.