健脾除湿、祛瘀解毒中药联合化疗对晚期大肠癌的疗效及安全性评估  

Efficacy and safety assessment on herbs invigorating spleen and removing dampness, blood stasis and toxin combined with chemotherapy in the treatment of advanced colorectal cancer

作　　者：李泓佳 石齐[1] 李文[1] 刘姗姗[1] 宗绍其 侯风刚[1] 

机构地区：[1]上海中医药大学附属上海市中医医院肿瘤科,200071

出　　处：《肿瘤研究与临床》2016年第4期256-261,共6页Cancer Research and Clinic

基　　金：上海市卫生和计划生育委员会中医药科研基金，上海市卫生局科委基金，上海市科学技术委员会科研计划项目(14401930800)Scientific Research Foundation of Traditional Chinese Medicine of Shanghai Health and Family Planning Commission，Scientific Research Foundation of Shanghai Health Bureau，Scientific Research Plan Project of Shanghai Science and Technology Committee

摘　　要：目的系统评价健脾除湿、祛瘀解毒中药联合化疗对晚期大肠癌的疗效和安全性是否优于单纯化疗。方法检索中国生物医学文献（CBM）、中国知网（CNKI）、万方数据（Wanfang Data）、维普（VIP）、PubMed、Embase数据库中2000年1月至2015年10月间关于中药联合化疗治疗晚期大肠癌的随机对照研究，采用Stata14．0软件进行统计分析。结果共纳入19篇文献、941例患者，其中中药联合化疗组487例，单纯化疗组454例。中药联合化疗组的1年（RR=1．28，95％CI1．14～1．45）、2年（RR=1．52，95％CI1．05～2．18）及3年（RR=2．76，95％CI1．56—4．88）生存率、实体瘤客观反应率（RR=1．11，95％CI 1．04～1．19）、Karnofsky评分（RR=1．46，95％CI1．27～1．68）、中医症状积分均较单纯化疗组显著提高（RR=1．58，95％CI1．33～1．75）；中药联合化疗组的以下不良反应发生率低于单纯化疗组：白细胞降低（RR=0．59，95％CI0．40～0．87）、恶心呕吐（RR=0．68，95％CI0．59～0．79）、腹泻（RR=0．67，95％CI0．53-0．85）、神经毒性（RR=0．79，95％CI 0．65～0．96）。结论与单纯化疗比较，健脾除湿、祛瘀解毒中药联合化疗能够提高晚期大肠癌患者的生存率，提高实体瘤客观反应率，化疗相关不良反应轻，患者生命质量改善。Objective To evaluate systematically whether or not the treatment of herbs invigorating spleen and removing dampness, blood stasis and toxin with chemotherapy is better than chemotherapy alone for advanced colorectal cancer. Methods The randomized controlled trails （RCT） involving combined treatment of herbs with chemotherapy, published from January 2000 to October 2015, were searched in CBM, CNKI, Wanfang Data, VIP, PubMed, Embase databases. Stata 14.0 software was used to analyze the data. Results 19 RCT containing 941 patients were included in this meta-analysis. Compared with chemotherapy alone, the combined treatment of Chinese herbal medicine and chemotherapy was obviously better in 1-year survival rate （RR = 1.28, 95 % CI 1.14-1.45）, 2-year survival rate （Rfl = 1.52, 95 % CI 1.05-2.18）, 3-year survival rate （RR = 2.76, 95 % CI 1.56-4.88）, objective response （trlR = 1.11, 95 % CI 1.04-1.19）, Karnofsky score （RR = 1.46, 95 % CI 1.27-1.68） and traditional chinese medicine （TCM） symptom score （RR = 1.58, 95 % CI 1.33-1.75）. The adverse effect rate was statistically reduced in the combined treatment group： leukopenia （RR = 0.59, 95 % （21 0.40-0.8）, nausea and vomiting （BR = 0.68, 95 % （21 0.59-0.79）, diarrhea （RB = 0.67, 95 % CI 0.53-0.85）, neurotoxieity （RR = 0.79, 95 % CI 0.65-0.96）. Conclusion Compared with chemotherapy alone, the treatment of herbs invigorating spleen and removing dampness, blood stasis and toxin combined with chemotherapy for advanced eoloreetal cancer can significantly increase survival rate and objective response rate, improve the quality of life, and meanwhile decrease the adverse effect rate.

关 键 词：结直肠肿瘤 药物疗法 中草药 Meta分析 

分 类 号：R735.34[医药卫生—肿瘤]