参苓白术散预防大肠癌化疗相关不良反应的Meta分析  

Shen Ling Baizhu Powder in Preventing Chemotherapy-related Adverse Reaction in Patients with Colorectal Cancer:A Meta-Analysis

作　　者：周锐 刘译鸿 马灏川 陈亚栋 朱燕娟 常雪松 张海波 ZHOU Rui;LIU Yi-Hong;MA Hao-Chuan;CHEN Ya-Dong;ZHU Yan-Juan;CHANG Xue-Song;ZHANG Hai-Bo(The Second Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510006 Guangdong,China;The Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510120 Guangdong,China;State Key Laboratory of Dampness Syndrome of Chinese Medicine,the Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510120 Guangdong,China)

机构地区：[1]广州中医药大学第二临床医学院,广东广州510006 [2]广州中医药大学第二附属医院,广东广州510120 [3]广州中医药大学第二附属医院省部共建中医湿证国家重点实验室,广东广州510120

出　　处：《广州中医药大学学报》2023年第2期508-515,共8页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广州中医药大学第二附属医院省部共建中医湿证国家重点实验室建设项目(编号:SZ2020ZZ20,SZ2021ZZ0204,SZ2021ZZ40)。

摘　　要：【目的】系统评价参苓白术散预防大肠癌化疗相关不良反应的效果。【方法】检索国内外主要数据库中参苓白术散预防大肠癌化疗相关不良反应的随机对照试验,依据文献纳入与排除标准筛选文献并提取相关数据;根据Cochrane Handbook推荐的文献质量评价工具对文献进行质量评价,使用Review Manager 5.4软件进行Meta分析。【结果】共纳入11篇文献,累计样本量849例。Meta分析结果显示,参苓白术散联合化疗可有效降低化疗所致的呕吐(RR=0.51,95%CI[0.37,0.71];P<0.000 1)、骨髓抑制(RR=0.51, 95%CI [0.37,0.72];P=0.000 1)、腹泻(RR=0.37, 95%CI [0.25,0.56];P<0.000 01)、肝肾功能损害(RR=0.49, 95%CI [0.27,0.87];P=0.02)、血小板下降(RR=0.17,95%CI [0.05,0.57];P=0.004)的发生风险。【结论】参苓白术散能有效预防大肠癌化疗相关不良反应。但因纳入研究的数量少,整体质量水平较低,结论仍需更多高质量、高等级的循证依据进一步论证。Objective To systematically evaluate the effectiveness of Shen Ling Baizhu Powder in preventing chemotherapy-related adverse reaction in colorectal cancer patients. Methods Randomized controlled trials(RCTs)of the prevention of chemotherapy-related adverse reactions in colorectal cancer with Shen Ling Baizhu Powder were retrieved from the primary domestic and oversea databases. The literature was screened according to the inclusion and exclusion criteria and then the relevant data were extracted. The quality of the literature was evaluated according to the quality assessment tools recommended by the Cochrane Handbook,and meta-analysis was carried out using Review Manager 5.4 software. Results A total of 11 RCTs with a cumulative sample size of849 cases were included. The results of meta-analysis showed that the combination of Shen Ling Baizhu Powder with chemotherapy was effective on reducing the risk of occurrence of chemotherapy-induced vomiting(RR =0.51,95% CI[0.37,0.71];P<0.000 1),bone marrow suppression(RR=0.51,95%CI [0.37,0.72];P =0.000 1),diarrhea(RR = 0.37, 95% CI [0.25,0.56];P<0.000 01),hepatic and renal impairment(RR =0.49,95% CI [0.27,0.87];P = 0.02),and decreased platelet count(RR = 0.17,95% CI [0.05,0.57];P =0.004). Conclusion Shen Ling Baizhu Powder is effective on preventing chemotherapy-related adverse reaction in colorectal cancer. However,due to the small amount of the included studies and the low overall quality level,the conclusion still needs to be further verified by more high-quality and high-grade evidences.

关 键 词：参苓白术散 大肠癌 化疗相关不良反应 呕吐 骨髓抑制 META分析 

分 类 号：R273.53[医药卫生—中西医结合]