槐耳颗粒联合西医疗法治疗原发性肝癌患者临床疗效的Meta分析

Meta-analysis of the clinical efficacy of huaier granule combined with western medicine treatment in the treatment of primary liver cancer

目的:系统评价槐耳颗粒联合西医疗法治疗原发性肝癌患者的临床疗效和安全性。方法:通过检索Pubmed、The Cochrane Library、中国知网(CNKI)、维普中文期刊数据库(VIP)、万方数据库、中国生物医学文献数据库(CBM),搜集2019年11月之前发表的槐耳颗粒联合西医疗法治疗原发性肝癌患者的随机对照试验。对纳入文献提取资料并进行质量评价。通过RevMan5.3软件,效应模型选择固定或随机效应模型,效应指标选择相对危险度(RR)或均数差(MD)进行Meta分析。结果:纳入22篇文献共2676例患者,干预组患者1533例,对照组患者1143例。Meta分析结果显示,槐耳颗粒联合西医疗法与西医疗法比较,能提高客观有效率(RR=1.39,95%可信区间[CI]:1.24~1.55,P<0.00001)、1年生存率(RR=1.43,95%CI:1.23~1.66,P<0.00001)、KPS评分(RR=1.29,95%CI:1.12~1.49,P=0.0005)和CD_(3)^(+)T淋巴细胞水平(MD=13.83,95%CI:8.84~18.82,P<0.00001)、CD_(4)^(+)T淋巴细胞水平(MD=9.85,95%CI:7.88~11.82,P<0.00001);降低胃肠反应发生率(RR=0.61,95%CI:0.46~0.81,P=0.0005)、骨髓抑制率(RR=0.44,95%CI:0.30~0.65,P<0.0001)。结论:槐耳颗粒联合西医疗法治疗原发性肝癌患者有利于提高临床疗效,安全性高,有临床推广的价值。

Objective:To systematically evaluate the clinical efficacy and safety of Huaier granule combined with Western medicine treatment for primary liver cancer.Methods:By searching Pubmed,the Cochrane Library,CNKI,VIP,Wanfang Database,CBM,randomized controlled trials of Huaier granule combined with western medicine treatment for primary liver cancer published up to November 2019 were collected.Data extraction and quality assessment were performed from the included literatures.Through RevMan5.3 software,the effect model was selected as fixed or random effect model,and the effect index was selected as relative risk(RR)or mean difference(MD)for meta-analysis.Results:A total of 2676 patients were included in 22 literatures,including 1533 patients in the intervention group and 1143 patients in the control group.The results of the meta-analysis showed that compared with western medicine therapy,huaier granule combined with western medicine treatment had significant increases in objective efficiency[RR=1.39,95%confidence interval(CI):1.24-1.55,P<0.00001],one-year survival rate(RR=1.43,95%CI:1.23-1.66,P<0.0001),karnofsky performance scale score(RR=1.29,95%CI:1.12-1.49,P=0.0005),and the level of CD3^(+)T lymphocytes(MD=13.83,95%CI:8.84-18.82,P<0.00001),CD_(4)^(+)T lymphocytes(MD=9.85,95%CI:7.88-11.82,P<0.00001);as well as remarkable reductions in incidence rate of gastrointestinal reactions(RR=0.61,95%CI:0.46-0.81,P=0.0005),rate of bone marrow suppression(RR=0.44,95%CI:0.30-0.65,P<0.0001).Conclusion:Compared with western medicine therapy,huaier granule combined with western medicine treatment for primary liver cancer is more conducive to improving clinical efficacy,higher safety,and has clinical promotion value.