补益剂联合肠内营养治疗结直肠癌术后的Meta分析

A Meta-analysis of the tonic prescripitions plus enteral nutrition on postoperative patients with colorectal cancer

目的:运用荟萃分析的方法,系统评价补益剂中药治疗结直肠癌术后的临床疗效。方法:计算机检索中国知识资源总库、中国学术期刊数据库、中文科技期刊数据库、中国生物医学文献数据库及Pumbed数据库2014年1月1日-2019年11月15日收录的有关中药联合肠内营养治疗结直肠癌术后的随机对照试验,按照纳入与排除标准进行文献筛选,采用考克兰系统评价手册对纳入文献进行质量评价,使用Revman5.3软件进行Meta分析。结果:筛选后共纳入文献8篇,包括789名结直肠癌术后患者,其中观察组403名,对照组386名,Meta分析结果显示:补益剂联合肠内营养可促进患者胃肠功能恢复,减少术后并发症,缩短结直肠癌术后首次排气时间,术后首次排便时间,补益剂联合肠内营养可促进患者营养水平提升,提高血清总蛋白水平,血清白蛋白水平,前白蛋白水平,提高免疫球蛋白G(Immunoglobulin G,IgG)、免疫球蛋白A(Immunoglobulin A,IgA)、免疫球蛋白M(Immunoglobulin M,IgM)水平,但在血红蛋白水平、免疫指标恢复上暂时未见明显疗效。结论:相较于单纯用肠内营养,补益剂联合肠内营养可更加有效减少结直肠癌术后并发症,促进患者术后胃肠功能恢复,营养指标、免疫指标提升。

Objective:To systematically evaluate the clinical efficacy of the tonic prescripitions on postoperative patients with colorectal cancer.Methods:Randomized controlled trials of the tonic prescripitions plus enteral nutrition on postoperative patients with colorectal cancer were retrieved from databases as CNKI,WangFang,CBM,VIP and Pumbed from January 1,2014 to November 15,2019.The selected literature was determined according to the inclusion and exclusion criteria,the quality of the included literature was evaluated according to the Cochrane Handbook for Systematic Reviews.A Meta-analysis was performed by RevMan5.3 software.Results:After screening,a total of 8 literatures were included,including 789 postoperative patients with colorectal cancer,including 403 patients in the observation group and 389 patients in the control group.In the results of Metaanalysis,the tonic prescripitions plus enteral nutrition on postoperative patients with colorectal cancer could reduce complication rate,promote recovery of gastrointestinal function,shorten the first time of flatus and defecation,improve postoperative albumin levels,increase total protein level,albumin level,prealbumin level,and augment IgG,IgA,IgM.There was no obvious effect in recovery of hemoglobin levels,immune indexes.Conclusion:Comparing with enteral nutrition therapy,the tonic prescripitions plus enteral nutrition on postoperative patients with colorectal cancer could reduce complication rate,promote recovery of gastrointestinal function,increase nutrition and immunity.