健脾方药治疗大肠癌术后患者随机对照试验的系统评价和Meta分析

正大肠癌是一种世界性的恶性肿瘤,随着我国居民生活水平提高,生活习惯及饮食结构的改变,尤其是高蛋白饮食比例的增加,大肠癌已成为我国发病率上升最快的消化道恶性肿瘤,其在恶性肿瘤中发病率和死亡率分别居第4位和第5位~1]。手术治疗是目前治疗大肠癌最主要的手段,化疗是术后最重要的治疗措施。《脾胃论》曰:"元气之充足皆有脾胃之元气无所伤,而后能滋养元气,若胃气之本弱,饮食自倍,则脾胃之气既伤,而元气亦不能充。"这说明脾

A Systematic Review and Meta-analysis of Randomized Controlled Trials:Postoperative Colorectal Cancer PatientsTreated with Invigorating Spleen Herbs

Objective] To review systematically the curative effect and safety of invigorating spleen herbs on patients with postoperative colorectal cancer. Methods]The domestic databases (CNKI, VIP, CBM, Wanfang), international databases (Pubmed, Cochrane Library) and American Clinical Trials Registration System were retrieved till Mar. 9, 2017. The randomized controlled trials (RCT) about the comparison in treatment of patients with invigorating spleen herbs combined with chemotherapy, chemotherapy alone were identified and included. The quality of included RCT extracted independently by two persons was reviewed according to recognized criterions provided by Cochrane Collaboration Network, and the effect was analyzed systematically and comprehensively by RevMan 5.3.5. The outcome index was relative risk (RR) or average difference (MD), both expressed as 95% confidence interval. Results] There were totally 23 RCT included (involving 2036 patients). The methodological quality of included RCT was generally lower. The summary shows that compared with chemotherapy alone, invigorating spleenherbs combined with chemotherapy has statistical difference in recent effect, quality of life, toxicity (leukopenia, thrombocytopenia, nausea and vomiting, diarrhea, peripheral neurotoxicity) (P<0.05), but not in the reduction of red blood cell (P>0.05). Conclusion] Compared with chemotherapy alone, invigorating spleen herbs combined with chemotherapy has advantages in improving the recent effect and quality of life, reducing toxicity after surgery of colorectal cancer, but more rigorous designed and large-sample clinical trials are needed for further confirmation.