Meta-analysis to Assess the Effectiveness and Safety of the Integration of Chinese Medicine and Chemotherapy in the Management of Stage Ⅲ～Ⅳ Pancreatic Cancer
Objective:To evaluate the efficacy and safety of traditional Chinese medicine combined with chemo-therapy in the treatment of stage Ⅲ-Ⅳ pancreatic cancer.Methods:Randomized controlled trials(RCTs)of traditional Chinese medicine combined with chemotherapy for stage Ⅲ-Ⅳ pancreatic cancer published from the establishment of the database to November 9,2023 were retrieved from CNKI,VIP,Wanfang,China Biomedical Literature Service Sys-tem(CBM),Pubmed,Embase,and The Cochrane Library databases.The patients were divided into experimental group(traditional Chinese medicine combined with chemotherapy group)and the control group(chemotherapy group),and the Meta-analysis was completed using RevMan5.4 software.Results:A total of 28 RCTs were included,with a total of 1829 patients.Meta-analysis results showed that compared with the control group,the experimental group had higher effec-tive rate[OR=1.96,95％CI(1.55,2.46),P<0.00001],KPS score[OR=3.91,95％CI(2.34,6.53),P<0.00001;MD=4.59,95％CI(2.51,6.67),P<0.0001],and TCM syndrome improvement rate[OR=4.51,95％CI(3.22,6.31),P<0.00001].The levels of tumor markers CA199[OR=2.19,95％CI(1.45,3.31),P=0.0002;MD=-30.31,95％CI(-50.42,-10.20),P=0.003]and CEA[OR=2.35,95％CI(1.03,5.32),P=0.04;MD=-2.54,95％CI(-2.93,-2.15),P<0.00001]were de-creased in the experimental group.In terms of side effects,the incidence of gastrointestinal reactions[OR=0.26,95％CI(0.18,0.37),P<0.00001]and bone marrow suppression[OR=0.28,95％CI(0.20,0.39),P<0.00001]in the experimental group was lower.At the same time,the incidence of nausea and vomiting[OR=0.35,95％CI(0.24,0.51),P<0.00001],diarrhea[OR=0.38,95％CI(0.21,0.69),P=0.001],leukopenia[OR=0.54,95％CI(0.35,0.84),P=0.006],thrombocyto-penia[OR=0.50,95％CI(0.32,0.79),P=0.003]and hemoglobin reduction[OR=0.55,95％CI(0.35,0.85),P=0.008]in the experimental group were significantly lower.According to the frequency analysis of Chinese medicine use,Atracty-lodes macrocephala,Licorice,Pinellia ternata,and Poria cocos are commonly used Chinese medicines for the treatment of stage Ⅲ-Ⅳ pancreatic cancer.Conclusion:Compared with chemotherapy alone,Chinese medicine combined with chemotherapy has better efficacy and safety in the treatment of stage Ⅲ-Ⅳ pancreatic cancer.
万方数据
维普
