八珍汤在提高恶性肿瘤患者免疫功能方面疗效Meta分析
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摘要
目的:运用Meta分析的方法,系统评价八珍汤在恶性肿瘤治疗中关于免疫功能的疗效。为八珍汤在恶性肿瘤辅助治疗中提高免疫功能的中医药治疗提供依据。方法计算机检索CNKI、WangFang Data、PubMed、EMbase、SinoMed、The Cochrane Library数据库,以"八珍汤"、"恶性肿瘤"、"癌"、"免疫功能"为关键词,搜集八珍汤在恶性肿瘤治疗中肿瘤相关免疫功能的临床疗效的随机对照试验(RCT),检索时限从2011年-2018年。主要结局指标:免疫功能(CD3+、CD4+、CD4+/CD8+、NK细胞)、KPS评分。由两名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Stata12.0软件进行Meta分析。结果共纳入文献12篇,共1167例患者。Meta分析结果显示:八珍汤在恶性肿瘤辅助治疗中不仅可以提高患者免疫功能的CD3+水平、CD4+水平、CD4+/CD8+水平、NK细胞水平,使其实验室指标得以提升(P<0.001),提高患者自身免疫力加强对抗肿瘤以及辅助放化疗提高其有效率,还可使肿瘤患者生活质量KPS评分提高(P<0.001),改善患者生活质量。八珍汤可在一定程度上提高肿瘤患者免疫功能,由于受纳入研究数量和质量的限制,但还需进一步开展高质量的试验加以证实。
Objective: Meta analysis was used to evaluate the efficacy of Bazhen decoction in the treatment of malignant tumor.Bazhen decoction in malignant tumor adjuvant therapy to improve the immune function of traditional Chinese medicine treatment to provide the basis.Methods To search the Cochrane Library database of CNKI/Wang Fang data Cochrane Library,the key words were "Bazhen decoction","malignant tumor","carcinoma" and "immune function".A randomized controlled trial of clinical efficacy of Bazhen decoction in the treatment of malignant tumor related immune function was collected.The search time was from 2011 to 2018.Main outcome measure: immunologic function(the score of CD3+,CD4 +,CD4+/CD8+,NK cell),KPS.The two researchers independently sifted the literature,extracted the data and evaluated the bias risk in the study.Meta analysis was performed with Stata12.0 software.Results:A total of 1167 patients were included in 12 articles.The results of Meta analysis showed that Bazhen decoction could not only improve the CD3+,CD4+ level of immune function and CD4+/CD8+ level in patients with malignant tumor,but also enhance the laboratory index of NK cell level(P<0.001).Neoplasms and adjutant radio chemotherapy improve their effectiveness,Kamofsky(KPS) of tumor patients was improved by KPS score(P<0.001),the quality of life was improved.Bazhen decoction is effective in improving the immune function of tumor patients to a certain extent.Due to the limitation of the quantity and quality of the study,it needs to be confirmed by further high quality experiments.
Objective: Meta analysis was used to evaluate the efficacy of Bazhen decoction in the treatment of malignant tumor.Bazhen decoction in malignant tumor adjuvant therapy to improve the immune function of traditional Chinese medicine treatment to provide the basis.Methods To search the Cochrane Library database of CNKI/Wang Fang data Cochrane Library,the key words were "Bazhen decoction","malignant tumor","carcinoma" and "immune function".A randomized controlled trial of clinical efficacy of Bazhen decoction in the treatment of malignant tumor related immune function was collected.The search time was from 2011 to 2018.Main outcome measure: immunologic function(the score of CD3+,CD4 +,CD4+/CD8+,NK cell),KPS.The two researchers independently sifted the literature,extracted the data and evaluated the bias risk in the study.Meta analysis was performed with Stata12.0 software.Results:A total of 1167 patients were included in 12 articles.The results of Meta analysis showed that Bazhen decoction could not only improve the CD3+,CD4+ level of immune function and CD4+/CD8+ level in patients with malignant tumor,but also enhance the laboratory index of NK cell level(P<0.001).Neoplasms and adjutant radio chemotherapy improve their effectiveness,Kamofsky(KPS) of tumor patients was improved by KPS score(P<0.001),the quality of life was improved.Bazhen decoction is effective in improving the immune function of tumor patients to a certain extent.Due to the limitation of the quantity and quality of the study,it needs to be confirmed by further high quality experiments.
引文
[1]李小军,冯春兰,罗海亮,等.八珍汤辅助放化疗治疗中晚期食管癌45例临床观察[J].中医杂志,2016,57(5)416-419.
[2]杨海霞,郭璟静,静茹.八珍汤加减联合艾灸对中晚期宫颈癌放化疗患者耐受力、止痛效果和生活质量的影响[J].中国实验方剂学杂志,2018,24(9)173-178.
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[7]杨永峰.八珍汤配合放化疗对中晚期食管癌患者免疫功能及生活质量的影响[J].河南医学研究,2017,26(12):2187-2188.
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[9]申学华,王本东.八珍汤配合放疗对中晚期宫颈癌的疗效分析[J].中国妇幼保健,2015(30):803-805.
[10]宋晓婕,周艳艳,赵莉娜.加味八珍汤联合放化疗对中晚期宫颈癌疗效及对患者T细胞亚群水平、血清肿瘤标志物表达及生存期的影响[J].中国实验方剂学杂志,2018,24(4):174-179.
[11]王宏星,李建平.胃癌术后八珍汤加减辅助肠内营养对生长激素、营养状况及免疫功能的影响[J].中国中西医结合杂志,2011,31(10):1317-1321.
[12]李绥邦,许延林.香砂八珍汤联合肠内营养对消化道肿瘤术后患者免疫功能的影响[J].中国实验方剂学杂志,2015,21(24):169-172.
[2]杨海霞,郭璟静,静茹.八珍汤加减联合艾灸对中晚期宫颈癌放化疗患者耐受力、止痛效果和生活质量的影响[J].中国实验方剂学杂志,2018,24(9)173-178.
[3]冯学明.八珍汤加减联合艾灸治疗癌因性疲乏的疗效[J].中华肿瘤防治杂志,2016(23):316-317.
[4]刘辉.八珍汤加减治疗胃癌术后化疗引起的胃肠道反应的疗效分析[J].中国现代药物应用2016年9月第10卷第18期;
[5]赵安斌,赵淑霞,王芳芳.八珍汤联合化疗治疗晚期肺癌的疗效观察[J]中国农村卫生,2016(16):41.
[6]蔡德珺,黎国伟,王唐恩,等.八珍汤联合瑞能对结肠癌术后化疗患者免疫增殖的影响[J].新中医,2016,48(9):156-159.
[7]杨永峰.八珍汤配合放化疗对中晚期食管癌患者免疫功能及生活质量的影响[J].河南医学研究,2017,26(12):2187-2188.
[8]高俊娈,范焕芳,孙春霞,等.八珍汤配合放疗对中晚期宫颈癌的疗效分析[J].中国中医基础医学杂志,2013,19(8):964-965.
[9]申学华,王本东.八珍汤配合放疗对中晚期宫颈癌的疗效分析[J].中国妇幼保健,2015(30):803-805.
[10]宋晓婕,周艳艳,赵莉娜.加味八珍汤联合放化疗对中晚期宫颈癌疗效及对患者T细胞亚群水平、血清肿瘤标志物表达及生存期的影响[J].中国实验方剂学杂志,2018,24(4):174-179.
[11]王宏星,李建平.胃癌术后八珍汤加减辅助肠内营养对生长激素、营养状况及免疫功能的影响[J].中国中西医结合杂志,2011,31(10):1317-1321.
[12]李绥邦,许延林.香砂八珍汤联合肠内营养对消化道肿瘤术后患者免疫功能的影响[J].中国实验方剂学杂志,2015,21(24):169-172.