八珍汤防治肿瘤放化疗所致骨髓抑制疗效的Meta分析

Meta-analysis of Bazhentang in the treatment of bone marrow inhibition caused by radiotherapy and chemotherapy

目的 探讨系统评价八珍汤对于防治肿瘤放化疗所致骨髓抑制的相关疗效,为中医药临床与相关实验研究提供必要的参考与依据。方法 通过检索中国知网(CNKI)、中国生物医学文献数据库(CBM)、Pub Med等中外文数据库,收集整理1975~2019年6月间八珍汤防治肿瘤放疗与化疗所致骨髓抑制的相关临床对照研究文献。对文献中报道的骨髓抑制发生情况、肿瘤近期疗效、白细胞总数(white blood cell,WBC)、中性粒细胞总数(neutrophil,NEU)、血红蛋白(hemoglobin,Hb)、血小板(platelet,PLT)与CD细胞(CD3、CD4、CD8与CD4/CD8)采用Review Manager 5.3软件进行数据分析,根据不同的数据类型采用相应的指标进行分析和结果描述。结果 共纳入随机对照试验(RCT)文献14篇,共计922例患者。Meta分析结果显示:八珍汤组治疗的骨髓抑制发生情况[OR=0.31,95%CI(0.23,0.43),P <0.000 01]、肿瘤近期疗效[OR=2.14,95%CI(1.33,3.43),P=0.002]、WBC[MD=1.12,95%CI(0.73,1.15),P <0.000 01]、NEU[MD=1.32,95%CI(0.92,1.72),P <0.000 01]、PLT[MD=0.61,95%CI(0.30,0.91),P <0.000 1]、CD3[MD=8.90,95%CI(4.26,13.54),P=0.000 2]、CD4[MD=9.47,95%CI(3.34,15.61),P=0.002]均优于对照组,且差异均具有统计学意义。2项研究报告了不良反应情况,但不良反应与八珍汤组本身治疗无关。结论 八珍汤在肿瘤放化疗所致骨髓抑制的防治中可以有效降低患者骨髓抑制的发生与提升肿瘤近期治疗效果,并可缓解放化疗所引发的WBC、NEU、PLT损伤水平且提升患者免疫功能的CD3与CD4细胞水平。

Objective To explore the efficacy of Bazhentang in the prevention and treatment of bone marrow depression (BMD) caused by radiotherapy and chemotherapy,and to provide necessary reference and basis for clinical and experimental studies of traditional Chinese medicine(TCM).Methods By searching CNKI,CBM,PubMed and other Chinese and foreign databases,we collected and collated the relevant randomized controlled trial of Bazhentang in the prevention and treatment of BMD caused by radiotherapy and chemotherapy from 1975 to June 2019.Review Manager 5.3 software was used to date analyze the occurrence of BMD,short-term curative effect of tumors,total white blood cell count (WBC),total neutrophil count(NEU),hemoglobin (Hb),platelet (PLT) and CD cells (CD3,CD4,CD8 and CD4/CD8) reported in the literature.The corresponding indicators are analyzed and the results are described.Results A total of 14 articles including 922 patients were included.Meta analysis results showed that Bone marrow suppression occurred[OR=0.31,95%CI (0.23,0.43),P<0.000 01],tumor recent efficacy[OR=2.14,95%CI(1.33,3.43),P=0.002],WBC[MD=1.12,95%CI(0.73,1.15),P<0.000 01],NEU[MD=1.32,95%CI (0.92,1.72),P<0.000 01],PLT[MD=0.61,95%CI(0.30,0.91),P<0.000 1],CD3[MD=8.90,95%CI (4.26,13.54),P=0.000 2],CD4[MD=9.47,95%CI (3.34,15.61),P=0.002]were superior to the control group,and the differences were significant.Two studies reported adverse reactions,but the adverse reactions were not related to the treatment of the Bazhen Tang group itself.Conclusion Bazhentang can effectively reduce the occurrence of BMD and improve the short-term therapeutic effect of cancer in the prevention and treatment of BMD used by radiotherapy and chemotherapy,and alleviate the damage level of WBC,NEU and PLT caused by radiotherapy and chemotherapy,and enhance the level of CD cells of patients'immune function.