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【目的】系统评价中医药联合化疗预防Ⅱ~Ⅲ期结直肠癌术后复发转移的疗效。【方法】计算机检索Pub Med、EMBase、Cochrane Library、中国期刊全文数据库(CNKI)、中文科技期刊数据库(VIP)、万方数据库、中国生物医学文献数据库(Sino Med)等,收集中医药联合化疗预防Ⅱ~Ⅲ期结直肠癌术后复发转移相关的随机对照试验(RCT),对纳入的RCT进行系统评价。【结果】共纳入7个RCT研究,涉及700例结直肠癌患者,中医药联合化疗组(治疗组)和单纯化疗组(对照组)的例数分别为355例和345例。Meta分析结果显示:治疗组在根治术后1、2、3年复发转移率控制方面均优于对照组,差异有统计学意义(P<0.05),但2组根治术后5年复发转移率相比差异无统计学意义(P>0.05);在延长复发转移时间、改善体力状况及缓解症状等方面,治疗组明显优于对照组,差异有统计学意义(P<0.05)。【结论】中医药联合化疗在预防Ⅱ~Ⅲ期结直肠癌术后复发转移方面疗效更显著,且能明显改善生活质量。但由于纳入研究的方法学质量较低,结果仍需要大样本、多中心、高质量的临床试验加以验证。
【Objective】 To systematically evaluate the curative effect of traditional Chinese medicine combined with chemotherapy in preventing postoperative recurrence and metastasis of stage Ⅱ ~ Ⅲ colorectal cancer. 【Methods】 Pub Med, EMBase, Cochrane Library, Chinese Journal Full-text Database (CNKI), Chinese Science and Technology Periodical Database (VIP), Wanfang Database and Sino Med were searched by computer. Randomized controlled trials (RCTs) associated with postoperative recurrence and metastasis of stage Ⅱ ~ Ⅲ colorectal cancer were performed to systematically evaluate the included RCT. 【Results】 A total of 7 RCTs involving 700 patients with colorectal cancer were enrolled. The number of cases treated with Chinese medicine combined with chemotherapy (treatment group) and chemotherapy alone group (control group) were 355 and 345, respectively. The results of Meta analysis showed that the treatment group was superior to the control group in the control of recurrence and metastasis at 1, 2 and 3 years after radical operation, with significant difference (P <0.05), but the recurrence and metastasis rate after 5 years (P> 0.05). The treatment group was significantly better than the control group in prolonging the recurrence and metastasis time, improving the physical condition and relieving the symptoms, the difference was statistically significant (P <0.05). 【Conclusion】 The combination of traditional Chinese medicine and chemotherapy in the prevention of recurrence and metastasis of stage Ⅱ ~ Ⅲ colorectal cancer is more effective, and can significantly improve the quality of life. However, due to the low quality of methodologies included in the study, results still need to be validated in large sample, multicenter, high-quality clinical trials.