中草药联合化疗治疗晚期大肠癌疗效分析

目的:评价中草药联合化疗治疗晚期大肠癌的临床研究的研究质量及疗效、生存质量、安全性。方法:通过计算机检索有关中草药联合化疗治疗晚期大肠癌的临床研究文献,检索数据库包括CNKI知识资源总库、维普数据库、万方数据库,检索限定时间为2003—2013年,采用Cochrane协作网提供的Rev Man5.0软件进行Meta分析。结果:共检索得到符合要求的文献23篇,研究质量Jadad评分在1~4分之间,均属低质量研究。对近期疗效、卡式评分、白细胞下降率进行Meta分析,OR值和95%可信区间分别为1.571.21~2.05]、3.992.98~5.34]、0.430.29~0.64]。结论:中草药联合化疗可提高晚期大肠癌患者的生活质量,减轻毒副反应,但研究的方法学质量偏低,尚不能作为可靠的临床应用证据,期待设计更合理、方法更科学、样本量更大、多中心的随机双盲对照临床试验,为中草药推广到临床提供更为可靠的证据。

Meta-analysis of Chinese Herbal Medicine Combined with Chemotherapy in Patients with Advanced Coloreetal Cancer

Objective： This Meta-analysis was performed to assess the efficacy and tolerability of Chinese herbal medicine combined with chemotherapy in patients with advanced colorectal cancer. Methods ： Randomized clinical trials on Chinese herbal medicine combined with chemotherapy in advanced colorectal cancer were identified by CNKI, VIP and Wanfang database during 2003-2013. Meta-analysis was performed by using the fixed effect model. Results ： 23 documents met the requirements and the Jadad scores were between 1 and 4 points, which belonged to the low quality research. Meta-analysis showed response rate OR=1.57,95% CI （ 1.21,2.05 ）, Karnofskey performances score OR=3.99,95% CI （2.98,5.34）and hematological toxicity OR=0.43,95% CI （ 0.29,0.64 ）. Conclusion ： The Chinese herbal medicine combined with chemotherapy can improve the life quality of patients with advanced eolorectal cancer and reduce adverse reaction. But the methodological quality of the studies is low, which can not be used as the evidence of clinical application. More reasonable and more scientific designed tlCTs with a larger sample size and multi-center are needed. The Chinese herbal medicine is extended to provide more reliable evidence for the clinic.