四君子汤加减联合西医常规疗法治疗胃癌的有效性及安全性Meta分析

A Meta-analysis of the safety and efficacy of the Sijunzi decoction plus Western medicine conventional therapy on gastric cancer

目的:系统评价四君子汤加减联合西医常规疗法治疗胃癌的疗效及安全性。方法:检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库以及PubMed、Embase、Cochrane Library、Web of Science等数据库,检索时间均从建库至2022年2月17日,纳入四君子汤加减联合西医常规疗法治疗胃癌的随机对照试验,根据Cochrane协作网偏倚风险评价标准对纳入研究进行方法学质量评价并采用RevMan 5.4软件进行Meta分析,得出结论。结果:共纳入17篇文献,1 338例患者。分析结果显示,四君子汤加减联合西医常规疗法治疗胃癌在提高临床总有效率、Karnofsky功能状态评分量表(Karnofsky Performance Status,KPS)评分,改善免疫功能指标T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))水平、患者生活质量、术后恢复,降低肿瘤标志物(糖类抗原-199)水平以及焦虑自评量表(Self-Rating Anxiety Scale,SAS)评分、抑郁自评量表(Self-rating Depression Scale,SDS)评分,减少不良反应方面等均优于西医常规疗法。结论:四君子汤加减联合西医常规疗法治疗胃癌疗效优于西医常规治疗,且安全性较高。但受纳入文献质量和数量的影响,上述结论仍需有更多大样本、多中心随机对照试验进一步验证。

Objective:To systematically evaluate the safety and efficacy of the Sijunzi decoction(四君子汤)plus Western medicine conventional therapy on gastric cancer.Methods:CNKI,Wanfang Database,VIP Database,CBM,PubMed,Embase,Cochrane Library,Web of Science and other databases were searched to retrieve the literature published from the establishment of the database to February 17,2022,and the randomized controlled trials(RCT)of the Sijunzi decoction plus Western medicine conventional therapy in the treatment of gastric cancer were included to evaluate the methodological quality according to Cochrane collaboration network bias risk assessment criteria.RevMan 5.4 software was used to carry out a Meta-analysis to draw the conclusion.Results:A total of 17 articles with 1338 patients were included.The analysis results showed that the Sijunzi decoction plus Western medicine conventional therapy on gastric cancer were better than Western medicine conventional therapy in improving the clinical total efficiency,KPS score,ameliorating immune function indicator T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+))levels,and the quality of life of patients,promoting postoperative recovery,and reducing tumor markers(carbohydrate antigen-199)level,SAS score,SDS score,and adverse reactions.Conclusion:The Sijunzi decoction plus Western medicine conventional therapy shows a better curative effect than Western medicine conventional therapy on gastric cancer,and has higher safety.However,affected by the quality and quantity of the included literature,the above conclusion still need to be further verified by more large-sample,multi-center RCTs.