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中药联合腹腔热灌注化疗治疗恶性腹水的疗效:系统评价与Meta分析

The efficacy of traditional chinese medicine combined with hyperthermic intraperitoneal chemotherapy for malignant ascites: A systematic review and meta-analysis.

作者信息

Lin Zhixian, Chen Jiangfeng, Liu Yunxia

机构信息

Department of Oncology, Hangzhou Third People's Hospital, Hangzhou, Zhejiang, China.

Department of Integrated Traditional Chinese & Western Medicine Oncology, Hangzhou Cancer Hospital, Hangzhou, Zhejiang, China.

出版信息

Front Pharmacol. 2022 Aug 29;13:938472. doi: 10.3389/fphar.2022.938472. eCollection 2022.

Abstract

Malignant ascites (MA) is a common complication of terminal cancer, which seriously affects the life quality and prognosis of patients. Both hyperthermic intraperitoneal chemotherapy (HIPEC) and traditional Chinese medicine (TCM) preparations have achieved significant efficacy in the treatment of MA. The treatment strategy of TCM combined with HIPEC has been gradually promoted and applied in China. The purpose of this systematic review and meta-analysis was to assess the efficacy of TCM combined with HIPEC in the treatment of MA. Randomized controlled trials (RCTs) of TCM combined with HIPEC for MA were searched from seven electronic databases. Two researchers used the Cochrane Collaboration's tool to assess the risk of bias. Excel 2019 was used to establish a database for information extraction, RevMan 5.4 software was used to analyze the included test data, and STATA v16.0 was used to conduct Egger's test to further detect publication bias. A total of 19 studies involving 1,504 patients were included in this meta-analysis. The results showed that compared with the single use of HIPEC, TCM combined with HIPEC could significantly improve the clinical efficacy (RR = 1.51, 95% CI [1.40, 1.63], < 0.00001) and karnofsky performance status (KPS) score (MD = 8.16, 95% CI [6.46, 9.85], < 0.00001), reduce the ascites volume (MD = -156.98, 95% CI [-213.71, -100.25], < 0.00001). However, there was no statistical significance in reducing abdominal circumference between TCM combined with HIPEC and HIPEC alone (MD = -1.8, 95% CI [-4.57, -0.97], = 0.2). This study found that TCM combined with HIPEC had a beneficial therapeutic effect on MA. However, more standard, double-blind, multicenter RCTs are needed to further confirm the efficacy of TCM combined with HIPEC in the treatment of MA. https://www.crd.york.ac.uk/, identifier CRD42022319993.

摘要

恶性腹水(MA)是晚期癌症的常见并发症,严重影响患者的生活质量和预后。热灌注化疗(HIPEC)和中药制剂在MA的治疗中均取得了显著疗效。中医联合HIPEC的治疗策略已在中国逐渐推广应用。本系统评价和荟萃分析的目的是评估中医联合HIPEC治疗MA的疗效。从七个电子数据库中检索了中医联合HIPEC治疗MA的随机对照试验(RCT)。两名研究人员使用Cochrane协作网的工具评估偏倚风险。使用Excel 2019建立信息提取数据库,使用RevMan 5.4软件分析纳入的试验数据,并使用STATA v16.0进行Egger检验以进一步检测发表偏倚。本荟萃分析共纳入19项研究,涉及1504例患者。结果显示,与单纯使用HIPEC相比,中医联合HIPEC可显著提高临床疗效(RR = 1.51,95%CI [1.40, 1.63],< 0.00001)和卡氏功能状态(KPS)评分(MD = 8.16,95%CI [6.46, 9.85],< 0.00001),减少腹水量(MD = -156.98,95%CI [-213.71, -100.25],< 0.00001)。然而,中医联合HIPEC与单纯HIPEC在减少腹围方面无统计学意义(MD = -1.8,95%CI [-4.57, -0.97],P = 0.2)。本研究发现,中医联合HIPEC对MA有有益的治疗作用。然而,需要更多规范、双盲、多中心的RCT来进一步证实中医联合HIPEC治疗MA的疗效。https://www.crd.york.ac.uk/,标识符CRD42022319993

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94d4/9467275/03e720aff5de/fphar-13-938472-g001.jpg

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