摘要
目的:系统评价以益气活血为主的方药联合化疗治疗原发性肝癌的疗效。方法:采用Cochrane系统评价方法,计算机检索电子检索Cochrane图书馆临床对照试验资料库、MEDLINE、EMBASE、PUBMED、万方数据库、中文科技期刊全文数据库(CNKI)、中国期刊全文数据库(VIP),检索时间均从建库至2014年1月,文种限于中、英文。按照纳入与排除标准选择文献,并根据Cochrane系统评价员手册5.1版推荐要求进行方法学质量的评估、数据的提取和Meta分析。结果:共纳入9个RCT研究,合计686例患者。方法学质量评价9个RCT均存在高度"偏倚性"风险。Meta分析显示:以益气活血为主的方药联合化疗治疗原发性肝癌在改善患者生活质量、提高近期疗效、减轻患者疼痛、减少白细胞下降发生率等方面具有疗效优势,优于单纯化疗组,差异有统计学意义[RR=1.84,95%CI(1.35,2.50),P=0.0001;RR=1.51,95%CI(1.21,1.88),P=0.0003;RR=1.62,95%CI(1.22,2.16),P=0.001;RR=0.37,95%CI(0.25,0.54),P=0.00001]。在改善患者腹水程度及延缓生存期上,联合用药患者疗效与单纯化疗者相当,差异无统计学意义[RR=1.31,95%CI(0.96,1.79),P=0.09;RR=1.06,95%CI(0.88,1.29),P=0.52;RR=1.31,95%CI(1.00,1.72),P=0.05]。结论:基于当前临床证据表明,以益气活血为主的方药联合化疗治疗原发性肝癌有助于减轻患者疼痛,提高其生活质量,降低不良反应发生率,近期疗效明显,优于单纯化疗法,值得临床借鉴,期待有高质量RCT研究进一步验证。
Objective： To evaluate the clinical effect of Yiqi Huoxue prescriptions dominated combined with chemotherapy to primary liver cancer（ PLC）. Methods： By cochrane systematic review methods,Cochrane Central Register of Controlled Trials,MEDLINE,EMBASE,PUBMED,Wanfang,CNKI,VIP were retrived by computer from building databases to January 2014. The text was confined to the Chinese and English. According to the inclusion and exclusion criteria to select literature,the methodological quality was assessed on the basis of the recommend requirement of Cochrane Handbook for Systematic Reviews 5. 1 version,extracted data and Meta-analysis. Results： Nine randomized trials were matched the selection criteria,including 686 patients. There were high bias on the 9 RCTs according to methodological quality assessment. Meta analysis showed that： combination therapy of Yiqi Huoxue prescriptions with chemotherapy group was better than the pure chemotherapy group,to PLC in improving quality of life,improving in the near future curative effect and relieve patients＇ pain,reducing the incidence of white blood cells decline had curative effect advantage,the differences were statistically significant [RR = 1. 84,95% CI（ 1. 35,1. 35）,P = 0. 0001; RR =1. 51,95% CI（ 1. 21,1. 21）,P = 0. 0003; RR = 1. 62,95% CI（ 1. 22,1. 22）,P = 0. 001; RR = 0. 37,95% CI（ 0. 25,0. 25）,P = 0. 00001]. On the improvement of patients with ascites and delay the survival,curative effect and the pure chemotherapy group,the differences were not statistical significance [RR = 1. 31,95% CI（ 0. 96,1. 79）,P = 0. 09; RR = 1. 06,95% CI（ 0. 88,1. 29）,P = 0. 52; RR = 1. 31,95% CI（ 1. 00,1. 72）,P = 0. 05]. Conclusion： Based on the current evidence from clinical,there are obvious advantages of combination therapy of Yiqi Huoxue prescriptions with chemotherapy group in the treatment of PLCin reducing pain,improving quality of life,improving the curative effect of recent chemotherapy and reducing the incidence of adverse reactions by compar
出处
《中西医结合肝病杂志》
CAS
2014年第4期248-253,共6页
Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases
基金
广西科技攻关项目(No.桂科攻1298003-2-12)
广西壮族自治区中医药管理局中医药面上重大项目(No.GZKZ-Z1103)
国家国际科技合作专项(No.2011DFA32620)
关键词
原发性肝癌
中医药
益气活血
化疗
META分析
primary liver cancer
traditional Chinese medicine
Yiqi Huoxue prescription
chemotherapy
Meta analysis
