| 夏红梅,尹卫华,史国军,罗小瑾.中医药联合化疗治疗老年肿瘤的meta分析[J].实用中西医结合临床,2016,16(5): |
| 中医药联合化疗治疗老年肿瘤的meta分析 |
| Meta-Analysis of Traditional Chinese Medicine Plus Chemotherapyin Treatment of elderly patients with cancer |
| 投稿时间：2016-03-26 修订日期：2016-04-21 |
| DOI： |
| 中文关键词: 中医药 化疗 老年肿瘤 随机试验 meta分析 |
| 英文关键词: |
| 基金项目: |
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| 摘要点击次数: 705 |
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| 中文摘要: |
| 目的：评价中医药联合化疗对老年肿瘤患者的临床获益及安全性。方法：检索中国期刊全文数据库、维普中文期刊数据库、万方学术期刊全文数据库等中文数据库中有关中医药联合化疗治疗老年肿瘤患者的随机对照实验,按照排除、纳入标准筛选后使用Reman软件进行Meta分析。结果：纳入21项RCT,共1705例老年肿瘤患者,试验组877 例,对照组828例；Meta 分析结果显示,①临床疗效(疾病控制率)：纳入17个RCT报告,各研究无异质性(P=0.5,I2=0%),采用固定效应模型,疾病控制率具有显著性差异［RR =2.74,95% CI( 1.62,2. 91) ,P ＜0.00001］。②KPS评分: 共有11个RCT 报告,经异质性检验证实无异质性(P=0.61,I2=0%),采用固定效应模型,KPS 评分,有显著性差异［RR =3.52,95% CI(2.48,4.99),P ＜ 0.00001］；③免疫功能: 共纳入3个RCT,各亚组研究存在异质性(P=0.03,I2=71%),采用随机效应模型,CD4差异均有统计学意义［SMD=1.38,95% CI( 0.82,1.94) ,P＜0.00001］。④胃肠道反应: 共纳入11个RCT,各亚组研究无异质性,采用固定效应模型,腹痛［RR = 0.12,95% CI( 0. 05,0.27) ,P ＜0.00001］,恶心呕吐［RR = 0.30,95% CI( 0. 26,0.53) ,P ＜0.00001］,有显著性差异；⑤肝肾功能：共纳入5个RCT研究,各亚组研究无异质性,采用固定效应模型,肝功能损害［RR = 0.28,95% CI( 0. 15,0.56) ,P=0.0002］,肾功能损害［RR = 0.41,95% CI( 0.19,0.87) ,P=0.02］,有统计学差异；血细胞毒性: 共纳入8个RCT,各亚组研究无异质性,采用固定效应模型,Ⅱ度以上白细胞减少［RR=0.53,95%CI( 0.42,0.69),P＜ 0.00001］,Ⅱ度以上血红蛋白下降［RR = 0.46,95%CI( 0.27,0.78),P= 0.004］,Ⅱ度以上血小板下降［RR = 0.29,95%CI( 0.14,0.66),P = 0.001］,具有显著性差异。结论：中医药联合化疗治疗老年肿瘤,在疾病控制率、提高生存质量、提高免疫功能、减轻骨髓抑制、减少胃肠道反应、肝肾功能损害等方面均优于单纯化疗；但由于本系统评价纳入研究的方法学质量较低,尚需开展更多设计合理、执行严格的多中心大样本且随访时间足够长的随机对照试验验证其疗效及安全性。 |
| 英文摘要: |
| Objective：To evaluate the effectiveness and safety of Traditional Chinese Medicine(TCM) in combination with chemotherapy versus chemotherapy for elderly patients with cancer. Methods：To collect all of RCTs with Traditional Chinese Medicine in combination with chemotherapy versus chemotherapy for elderly patients with cancer from CNKI,CBM, VIP and Wanfang in the chinese databases(2005 to 2015), which was analyzed according to the Cochrane Handbook for Systematic Reviews. Results：21 studies involving 1705 patients were included,with 877 patients in the experimental group of Traditional Chinese Medicine in combination with chemotherapy and the rest in the control group of chemotherapy(828).The experimental group was superior to the control group in disease control rate,enhancing the quality of life and immune function,being lower adverseness in gastrointestinal adverse reactions,liver renal toxicity and hematotoxicity. Conclusion: Traditional Chinese medicine plus chemotherapy is more effective in comparison with chemotherapy in elderly patients with cancer．It can improve KPS score, immune function and survival rate, and reduce gastrointestinal reaction and blood toxicity．But the quality of studies is low,more large-scale multi-center randomized trials are needed． |
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