基于现代文献分析癌因性疲乏的中医证治规律  

Analysis on the Rule of Syndrome and Therapy About Chinese Medicine on Intervening Cancer Related Fatigue Based on Literature Study

作　　者：谷珊珊 宋卓 李蒙[2] 于明坤 许云[1] GU Shan-shan;SONG Zhuo;LI Meng;YU Ming-kun;XU Yun(Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091;Hubei Provincial Hospital of Traditional Chinese Medicine,Hubei University of Chinese Medicine,Wuhan Hubei 430060;Beijing University of Traditional Chinese Medicine,Evidence-based Medical Center,Beijing 100029)

机构地区：[1]中国中医科学院西苑医院,北京100091 [2]湖北中医药大学湖北省中医院,湖北武汉430060 [3]北京中医药大学循证医学中心,北京100029

出　　处：《世界中西医结合杂志》2020年第12期2198-2203,2215,共7页World Journal of Integrated Traditional and Western Medicine

基　　金：2018年国家重点研发计划“中医药现代化研究”重点专项项目(2018YFC1707406)。

摘　　要：目的通过对近年来发表的中医干预癌因性疲乏(CRF)的随机对照试验文献进行分析,探求CRF的中医证治规律,为临床治疗CRF提供参考依据。方法计算机检索中国知网(CNKI)、万方(Wanfang Data)、维普(VIP)数据库,检索时间从建库至2019年12月30日,按照纳入和排除标准对中医治疗癌因性疲乏的随机对照试验(RCT)进行筛选,按照Cochrane Handbook标准提取资料及质量评价,用Excel软件进行统计分析。结果共纳入137项研究,共11854例患者,均采用中医疗法治疗CRF。结果显示:64.20%以Ⅲ~Ⅳ期肿瘤患者为干预对象,化疗所致CRF占52.55%、放疗所致CRF占2.19%,47.45%为肿瘤本身所致CRF。中医辨证CRF以虚证为主,主要分为气血两虚(37.44%)、气阴两虚(18.64%)、脾虚湿盛(6.38%)、脾气虚(16.22%)、脾肾亏虚(15.05%)、肺肾阴虚(6.26%)6个证型。中药干预涉及扶正类39种,扶正祛邪类21种,其中以汤剂最多,占51.09%,组方以"参类制剂"常见,中成药静脉注射液占29.20%,中成药口服制剂占19.71%。用药功效分类前3位为补虚药(51种),清热药(20种)、活血化瘀药(17种)。与其他干预措施相比,中医治疗在缓解疲乏状态、改善贫血,改善免疫功能,降低或减轻感染、骨髓抑制等方面更具优势。结论中医药治疗CRF多以补虚为主,强调益气养血、温阳滋阴之法,同时根据辨证不同佐以清热解毒、化痰祛湿、行气逐瘀药物;中医干预CRF不仅可以提高其免疫功能,还可以改善其贫血状态。Objective To analyze the randomized controlled trial literature of Chinese medicine intervention on cancer-related fatigue(CRF)published in recent years to explore the TCM syndromes and treatment rules of CRF,and to provide reference for clinical treatment of CRF.Methods CNKI,Wanfang Data,and VIP database were searched from inception to December 30,2019.RCTS of CM for CRF were screened and data was extracted.The quality of literatures was assessed according to Cochrane Handbook.Statistical analysis was performed by EXCEL.Results A total of 137 studies were included,with a total of 11854 patients,all of whom were treated with Chinese medicine for CRF.The results showed that 64.20%of patients with stageⅢ-Ⅳtumors were targeted for intervention,52.55%of CRF caused by chemotherapy,2.19%of CRF caused by radiotherapy,and 47.45%of CRF caused by the tumor itself.CRF based on TCM syndrome differentiation is mainly based on deficiency syndromes,mainly divided into deficiency of both qi and blood(37.44%),deficiency of both qi and yin(18.64%),spleen deficiency and dampness(6.38%),spleen deficiency(16.22%),spleen and kidney deficiency(15.05%),lung and kidney yin deficiency(6.26%)6 syndrome types.Traditional Chinese medicine intervention involves 39 types of strengthening the body,21 types of strengthening the body and eliminating evils,of which decoctions account for up to 51.09%.The prescription is commonly used as"ginseng preparations".Chinese patent medicine intravenous injection accounts for 29.20%,and Chinese patent medicine oral preparations account for 19.71%.The top 3 in the classification of medication efficacy are tonic drugs(51 types),heat-clearing drugs(20 types),and blood-activating drugs(17 types).Compared with other interventions,TCM treatment has more advantages in alleviating fatigue,improving anemia,improving immune function,reducing or reducing infection,and bone marrow suppression.Conclusion The treatment of CRF with TCM mainly focuses on replenishing deficiency,emphasizing the methods of replenishing q

关 键 词：癌因性疲乏 随机对照试验 中医药 辨证规律 方药 

分 类 号：R273[医药卫生—中西医结合]