槐耳颗粒辅助治疗原发性肝癌的系统评价

系统评价槐耳颗粒辅助治疗原发性肝癌的疗效及安全性.计笋机检索CNKI,Wanfang,VIP,CBMdisc,PubMed,Cochrane Library,EMbase数据库,检索时间为建库至2020年1月,全面检索槐耳颗粒联合西医疗法治疗原发性肝癌的随机对照试验.研究者对纳入文献进行资料提取及质量评价,运用RevM...

Systematic evaluation of Huaier Granules adjuvant treatment of primary liver cancer

To systematically evaluate the efficacy and safety of Huaier Granules in the adjuvant treatment of primary liver cancer.The databases of CNKI,Wanfang,VIP,CBMdisc,PubMed,Cochrane Library and EMbase were searched by computer to screen out the randomized controlled trial on Huaier Granules combined with Western medicine in the treatment of primary liver cancer from the establishment of the databases to January 2020.Data extraction and quality evaluation were conducted for the included literature.Meta-analysis was conducted with RevMan 5.3 software,and evidence quality evaluation was conducted for the outcomes by GRADE profiler software.A total of 24 articles were included,with a total sample size of 2664 cases.Meta-analysis showed that as compared with Western medicine alone,Huaier Granules combined with Western medicine could improve the objective remission rate(RR=1.38,95%CI[1.26,1.51],P<0.00001),disease control rate(RR=1.29,95%CI[1.10,1.52],P=0.002)and 6-month survival rate(RR=1.20,95%CI[1.10,1.32],P<0.0001),1-year survival rate(RR=1.39,95%CI[1.23,1.58],P<0.00001),2-year survival rate(RR=1.95,95%CI[1.28,2.96],P=0.002),KPS score(MD=17.15,95%CI[6.47,27.83],P=0.002)and the improvement rate of KPS score(RR=2.02,95%CI[1.47,2.77],P<0.0001),AFP decline rate(RR=1.40,95%CI[1.20,1.62],P<0.0001),CD3⁺(MD=17.34,95%CI[9.28,25.40],P<0.0001),CD4⁺(MD=8.62,95%CI[1.59,15.64],P=0.02),CD8⁺(MD=1.95,95%CI[-3.93,7.82],P=0.52),CD4⁺/CD8⁺(MD=0.42,95%CI[-0.33,1.17],P=0.27);reduce the level of AFP(MD=-71.57,95%CI[-80.42,-62.72],P<0.00001),recurrence rate(RR=0.76,95%CI[0.67,0.85],P<0.00001),and incidence of adverse reactions(RR=0.60,95%CI[0.41,0.89],P=0.01)in patients with primary liver cancer.According to the GRADE system,the evidence for outcome measures was low to very low.The results show that Huaier Granules have certain efficacy and high safety in adjuvant treatment of primary liver cancer,but its effect in reducing adverse reactions and improve immunity remains to be verified.Due to the poor quality of the included studies and evidences,the conclusions still need to be further verified by multi-center,large sample,and randomized double-blind controlled studies.