中药联合化疗防治根治术后局部进展期胃癌复发转移的Meta分析

目的 通过Meta分析探索中医药联合化疗防治局部进展期胃癌（LAGC）术后复发转移的有效性及安全性，评价中医药提高辅助化疗期间患者生活质量、免疫功能、减轻不良反应的作用。方法 计算机检索CNKI、Wanfang、PubMed等数据库相关随机对照临床研究。对研究文献进行筛选与数据提取，应用Cochrane提供的review manager 5.3软件进行Meta分析。结果 共纳入18个RCTs，Meta分析显示，对比单纯化疗，中医药联合化疗可以提高LAGC术后KPS评分、提高CD3⁺指标、提高CD4⁺/CD8⁺，降低术后白细胞减少、血红蛋白减少、血小板减少、恶心呕吐症状、腹泻、神经系统毒性反应发生率。在术后QLQ-C30评分以及肝、肾功能异常发生率方面，中医药联合化疗与单纯化疗疗效相当；中医药联合化疗可以降低LAGC术后1年、2年、3年、5年累计复发转移率，延长DFS。结论 中医药联合化疗对比单纯化疗可提高LAGC术后患者免疫水平及KPS评分，降低不良反应发生率，降低LAGC术后累计复发转移率，提高DFS。

Traditional Chinese Medicine Combined with Chemotherapy in Prevention and Treatment of Recurrence and Metastasis of Locally Advanced Gastric Cancer After Radical Resection: A Meta-analysis

Objective To explore the efficacy and safety of traditional Chinese medicine(TCM) combined with chemotherapy in the prevention and treatment of postoperative recurrence and metastasis of locally advanced gastric cancer (LAGC) by meta-analysis. Moreover, we evaluated the efficacy of TCM on the quality of life, immune indexes, and toxic and side effects during adjuvant chemotherapy. Methods The CNKI, Wanfang, PubMed, and other databases were searched by computer. Randomized controlled trials (RCTs) were searched. After literature screening and data extraction, Review Manager 5.3 software provided by Cochrane was used for meta-analysis. Results A total of 18 RCTs were included. Compared with chemotherapy alone, TCM combined with chemotherapy could improve the KPS score and CD3⁺ and CD4⁺/CD8⁺ index levels. The incidence rates of postoperative leucopenia, hemoglobin reduction, thrombocytopenia, nausea and vomiting, diarrhea, and neurotoxicity were reduced. In terms of postoperative QLQ-C30 score, abnormal liver function, and abnormal renal function, the incidence of TCM combined chemotherapy was similar to that of chemotherapy alone, with no statistical difference. Compared with chemotherapy alone, TCM combined chemotherapy could reduce the 1-, 2-, 3-, and 5-year cumulative recurrence and metastasis rates and prolong the disease-free survival time. Conclusion Compared with chemotherapy alone in adjuvant chemotherapy, TCM combined chemotherapy could improve the immune level and KPS score of LACC patients after surgery, reduce the incidence of adverse reactions, as well as reduce the recurrence and metastasis rate of LAGC after surgery and DFS could be improved.