口服中药改善结直肠癌辅助化疗所致骨髓抑制的系统评价和Meta分析

Effectiveness of Oral Chinese Medicine for Myelosuppression Induced by Adjuvant Chemotherapy in Patients with Colorectal Cancer: A Systematic Review and Meta-analysis

目的评价口服中药防治结直肠癌辅助化疗所致的骨髓抑制的疗效。方法在8个电子数据库检索建库至2021年1月20日相关文献。两名研究者按照纳入、排除标准独立进行文献筛选和数据提取,运用RevMan 5.3对纳入的文献进行偏倚风险评估和数据合成。结果研究共纳入37篇文献,全部为随机对照临床研究,共涉及受试者2705名。Meta分析结果显示,口服中药在降低结直肠癌辅助化疗所致的白细胞减少发生率、贫血发生率、血小板减少发生率、中性粒细胞减少发生率等方面具有疗效;在提高血小板计数、红细胞计数、白细胞计数、血红蛋白上没有显示出疗效。结论口服中药可降低结直肠癌辅助化疗所致的白细胞减少、贫血、血小板减少、中性粒细胞减少的发生风险。临床实践中,可考虑推荐口服中药用于防治结直肠癌辅助化疗所致的骨髓抑制。

Objective To evaluate the efficacy of oral Chinese Medicine(CM) on the prevention and treatment of bone marrow suppression caused by adjuvant chemotherapy in patients with colorectal cancer. Methods Eight electronic databases were searched from their inception to January 20, 2021. Two reviewers independently conducted the screening and data extraction. Methodological quality was assessed using the Risk of Bias tool. RevMan 5.3 was applied to evaluate the risk of bias and meta-analysis. Results A total of 37 documents were included in the study, all of which were RCTs, involving a total of 2705 subjects. Meta-analysis results showed that oral CM significantly reduced the incidence of leukopenia, hemoglobin reduction, thrombocytopenia, and neutropenia induced by adjuvant chemotherapy. However,oral CM was not helpful for increasing platelet count, red blood cell count, white blood cell count, and hemoglobin.Conclusion Oral CM can be effective in reducing the incidence of leukopenia, anemia, thrombocytopenia, and neutropenia induced by adjuvant chemotherapy. It can be recommended to patients with colorectal cancer for the prevention and treatment of myelosuppression caused by adjuvant chemotherapy.