中医温阳方治疗乳腺癌化疗患者疗效的Meta分析  

Meta-analysis of Curative Effect of Warming Yang Decoctions of Traditional Chinese Medicine for Patients with Breast Cancer with Chemotherapy

作　　者：马文静 陈震霖[1] 张硕[2] 王苗[3] 王红艳[3] 高甜甜 王璐 MA Wenjing;CHEN Zhenlin;ZHANG Shuo;WANG Miao;WANG Hongyan;GAO Tiantian;WANG Lu(Shaanxi University of Chinese Medicine,Xianyang 712046,China;Beijing University of Chinese Medicine,Beijing 100029,China;Department of Dermatology,the Second Affiliated Hospital of Shaanxi University of Chinese Medicine,Xi′an 712044,China)

机构地区：[1]陕西中医药大学,陕西咸阳712046 [2]北京中医药大学,北京100029 [3]陕西中医药大学第二附属医院皮肤科,西安712044

出　　处：《医学综述》2022年第6期1210-1218,共9页Medical Recapitulate

基　　金：国家自然科学基金(81974584);陕西省重点研发计划项目(2022SF-040);陕西中医药大学研究生创新项目(2021CX15)。

摘　　要：目的系统评价中医温阳方治疗乳腺癌化疗患者的疗效与安全性。方法检索中国知网、维普、万方、中国生物医学文献数据库、PubMed、Web of Science、Blackwell-Synergy、Embase、MD Consult、Medline数据库中有关温阳方治疗乳腺癌化疗患者的随机对照试验,检索时间为建库至2021年10月。根据纳入和排除标准,在Note Express 3.2.0和EndNote X 9.3.3中对文献进行细致筛选,对各项试验采用Cochrane偏倚风险评估工具进行偏倚评估,采用RevMan 5.3软件进行数据分析。结果最终纳入10项随机对照试验,共691例患者。治疗后,试验组临床疗效优于对照组(RR=1.62,95%CI 1.30~2.02,P<0.0001)。试验组患者的癌胚抗原、糖类抗原(CA)125和CA153水平均低于对照组(MD=-2.08,95%CI-4.08~-0.09,P=0.04;MD=-13.10,95%CI-14.31~-11.89,P<0.00001;MD=-7.81,95%CI-11.86~-3.76,P=0.0002)。试验组患者卡氏评分改善率高于对照组(RR=1.59,95%CI 1.17~2.17,P=0.003)。试验组患者CD3+、CD4+和自然杀伤细胞水平高于对照组(MD=10.00,95%CI 5.18~14.81,P<0.0001;MD=10.14,95%CI 4.72~15.57,P=0.0002;MD=2.94,95%CI 0.76~5.12,P=0.008),两组CD8+和CD4+/CD8+比较差异无统计学意义(P>0.05)。试验组红细胞、白细胞、血小板减少率及消化道不良反应发生率低于对照组(RR=0.63,95%CI 0.45~0.89,P=0.008;RR=0.61,95%CI 0.45~0.81,P=0.0009;RR=0.55,95%CI 0.41~0.74,P<0.0001;RR=0.59,95%CI 0.47~0.75,P<0.0001)。结论温阳方不仅能显著提高乳腺癌患者的化疗效果,降低血清肿瘤标志物水平,还能提高卡氏评分及免疫细胞指数,增强患者免疫力,且能减少化疗过程中的不良反应,提高用药安全性。Objective To systematically evaluate the efficacy and safety of warming yang decoctions of traditional Chinese medicine(TCM)for patients with breast cancer with chemotherapy.Methods From the establishment of the database to Oct.2021,in CNKI,VIP,Wanfang Data,CBM,PubMed,Web of Science,Blackwell-Synergy,Embase,MD Consult,Medline,the randomized controlled trials of warming yang decoctions for patients with breast cancer with chemotherapy were searched,and according to the inclusion and exclusion criteria,the literature was screened in Note Express 3.2.0 and EndNote X 9.3.3.The Cochrane bias risk assessment tool was used for bias assessment for each trial,and RevMan 5.3 software was used for data analysis.Results Finally,10 researches,with 691 patients were included.After treatment,the clinical efficacy of the trial group was better than the control group(RR=1.62,95%CI 1.30-2.02,P<0.0001).The levels of carcinoembryonic antigen(CEA),carbohydrate antigen(CA)125 and CA153 in the trial group were lower than those in control group(MD=-2.08,95%CI-4.08--0.09,P=0.04;MD=-13.10,95%CI-14.31--11.89,P<0.00001;MD=-7.81,95%CI-11.86--3.76,P=0.0002).The improvement rate of Cartesian score in the trial group was higher than that in the control group(RR=1.59,95%CI 1.17-2.17,P=0.003).The levels of CD3+,CD4+and natural killer cells in the trial group were higher than those in the control group(MD=10.00,95%CI 5.18-14.81,P<0.0001;MD=10.14,95%CI 4.72-15.57,P=0.0002;MD=2.94,95%CI 0.76-5.12,P=0.008),there was no significant difference in CD8+and CD4+/CD8+between the two groups(P>0.05).The incidences of red blood cells,white blood cells,platelets reduction and digestive tract adverse reactions in the trial group were lower than those in the control group(RR=0.63,95%CI 0.45-0.89,P=0.008;RR=0.61,95%CI 0.45-0.81,P=0.0009;RR=0.55,95%CI 0.41-0.74,P<0.0001;RR=0.59,95%CI 0.47-0.75,P<0.0001).Conclusion Warming yang decoctions not only can significantly improve the chemotherapeutic effect,reduce the serum tumor markers of the breast cancer patients,but

关 键 词：乳腺癌 温阳方 中医 META分析 

分 类 号：R273[医药卫生—中西医结合]