中西医结合治疗骨转移癌疗效的Meta分析  

Meta-analysis of the efficacy of integrated traditional Chinese and western medicine for bone metastatic cancer

作　　者：杨梦霞 毛昀 朱世杰[1] 芦殿荣[1] YANG Mengxia;MAO Yun;ZHU Shijie;LU Dianrong(Department of Oncology,Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China;Graduate School,Beijing University of Chinese Medicine,Beijing 100029,China;Department Oncology Hematology,the Second Affiliated Hospital of Hu’nan University of Chinese Medicine,Changsha 410005,Hu’nan,China)

机构地区：[1]中国中医科学院望京医院肿瘤科,北京100102 [2]北京中医药大学研究生院,北京100029 [3]湖南中医药大学第二附属医院肿瘤血液科,长沙410005

出　　处：《癌症进展》2022年第23期2397-2401,共5页Oncology Progress

基　　金：国家自然科学基金(81973640);中国中医科学院望京医院基础研究苗圃培育计划课题(WJYY-YJKT-2022-05);中国中医科学院望京医院院级科研课题(WJYY2020-26)。

摘　　要：目的系统评价中西医结合治疗骨转移癌的临床疗效。方法检索Cochrane Library、PubMed、Embase、中国生物医学文献服务系统、中国知网、万方数据库和维普数据库发表的关于中西医结合治疗骨转移癌的随机对照试验(RCT),检索时间为建库至2020年11月。由两位评价者独立对纳入研究的质量进行严格评价和资料提取后,采用RevMan 5.3软件进行Meta分析。结果最终纳入25篇文献,Meta分析显示,与西医常规干预相比,中西医结合干预能够有效缓解恶性肿瘤骨转移灶的骨质破坏(RR=1.41,95%CI:1.21~1.64,P﹤0.01),缓解恶性肿瘤骨转移引起的疼痛(RR=1.56,95%CI:1.40~1.74,P﹤0.01),提高恶性肿瘤骨转移患者的卡氏功能状态(KPS)评分(RR=1.69,95%CI:1.51~1.89,P﹤0.01),改善恶性肿瘤骨转移患者的中医证候(RR=1.58,95%CI:1.39~1.80,P﹤0.01)和活动能力(RR=1.32,95%CI:1.15~1.52,P﹤0.01)。结论中西医结合干预能够有效减轻恶性肿瘤骨转移,缓解癌痛,提高KPS评分,改善中医证候及活动能力。但本Meta分析纳入文献的方法学质量较低,且样本量少,因此中西医结合治疗骨转移癌的疗效仍需要严格的、大样本的随机双盲试验加以验证。Objective To systematically evaluate the clinical efficacy of integrated traditional Chinese and western medicine in the treatment of bone metastatic cancer.Method The Cochrane Library,PubMed,Embase,Sinomed,CNKI,Wanfang and VIP database were searched for the randomized controlled trial(RCT)of integrated traditional Chinese and western medicine in the treatment of bone metastatic cancer from the establishment of databases to November 2020.The strict quality evaluation and data extraction of included trials were conducted independently by two researchers and Meta-analysis was performed by using RevMan5.3 software.Result Totally 25 literatures were included into the study.The Meta-analysis results showed that compared with the routine intervention of western medicine,integrated traditional Chinese and western medicine effectively reduced the bone destruction caused by bone metastasis(RR=1.41,95%CI:1.21-1.64,P<0.01),alleviated cancer pain(RR=1.56,95%CI:1.40-1.74,P<0.01),improved Karnofsky performance status(KPS)score(RR=1.69,95%CI:1.51-1.89,P<0.01),improved traditional Chinese medicine(TCM)syndrome(RR=1.58,95%CI:1.39-1.80,P<0.01)as well as mobility(RR=1.32,95%CI:1.15-1.52,P<0.01).Conclusion The integrated traditional Chinese and western medicine can effectively alleviate bone metastasis and cancer pain,improve the KPS score,and improve the TCM syndrome and mobility.However,due to the low quality of methodology and small sample size of included RCT in this study,more randomized,double-blind trials with large sample size are required to further verify the efficacy of the integrated traditional Chinese and western medicine in the treatment of bone metastatic cancer.

关 键 词：中西医结合 骨转移癌 随机对照试验 META分析 

分 类 号：R738.1[医药卫生—肿瘤]