摘要
目的:系统评价四君子汤加减联合化疗对于常见恶性肿瘤(包括结直肠癌、肺癌、肝癌及食管癌)患者免疫功能的改善作用,以期对临床用药有一定启发。方法:通过中国知网(CNKI)、维普数据库(VIP)、万方数据库、Pubmed和Nature Publishing Group数据库,语种限于中、英文,对2000年1月—2019年12月国内发表的、符合纳入标准的文献进行检索、资料提取和质量评价,应用Revman 5.3软件进行Meta统计学分析。结果:共纳入13组随机对照试验,包括956例样本,其中对照组474例、观察组482例;中位治疗时间8周。分析结果提示四君子汤加减联合化疗可有效提高恶性肿瘤患者外周血CD3^(+)(%)、CD4^(+)(%)、CD4^(+)/CD8^(+)及NK(%)水平且有效降低恶性肿瘤患者外周血CD8^(+)(%)水平,其疗效优于单纯化疗,差异具有统计学意义;对提高外周血IgA、IgM、IgG及降低不良反应发生率亦有一定作用。结论:现有资料表明,四君子汤加减联合化疗对KPS评分在60分以上、预计生存期>6个月的恶性肿瘤患者的免疫(主要是细胞免疫)功能较单纯化疗有显著提高。但受纳入病例数量及试验风险、发表偏倚的限制,仍需要有更多高质量、低风险的大样本、多中心、随机双盲对照试验来验证此结果,以进一步指导临床用药。
Objective:To systematically evaluate the effect of Sijunzi Tang combined with chemotherapy on immune function of patients with common malignant tumors(including colorectal cancer,lung cancer,liver cancer and esophageal cancer),so as to provide some inspiration for clinical medication.Methods:Through CNKI,VIP,Wanfang,PubMed and Nature Publishing Group databases,the literatures published in China from January 2000 to December 2019 that met the inclusion criteria were searched,extracted and evaluated.Revman 5.3 software was used for meta-analysis.Results:A total of 13 groups of randomized controlled trials were included,including 956 samples,474 cases in the control group and 482 cases in the observation group;The median treatment time was 8 weeks.The results show that Sijunzi Tang Combined with chemotherapy can effectively improve the levels of CD3^(+)(%),CD4^(+)(%),CD4^(+)/CD8^(+)and NK(%)in peripheral blood of patients with malignant tumor,and effectively reduce the level of CD8^(+)(%)in peripheral blood of patients with malignant tumor.Its curative effect is better than that of chemotherapy alone,and the difference is statistically significant;It can also improve the peripheral blood IgA,IgM,IgG and reduce the incidence of adverse reactions.Conclusion:the existing data show that Sijunzi Tang combined with chemotherapy can significantly improve the immune(mainly cellular immune)function of patients with malignant tumor whose KPS score is more than 60 and the expected survival time is more than 6 months.However,due to the limitations of the number of included cases,the risk of trials and publication bias,more high-quality,low-risk,large sample,multi center,randomized double-blind controlled trials are needed to verify the results,so as to further guide clinical medication.
作者
孙修纯
马嘉泽
李沁园
方志军
Sun Xiuchun;Ma Jiaze;Li Qinyuan;Fang Zhijun(Nanjing Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing 210028,China;Nanjing Hospital of Traditional Chinese Medicine,Nanjing 210028,China;Jiangsu Academy of Traditional Chinese Medicine,Nanjing 210028,China)
出处
《亚太传统医药》
2021年第6期134-141,共8页
Asia-Pacific Traditional Medicine
基金
江苏省中医药管理局重点课题(JD2019SZXZD06)
作者简介
孙修纯(1996-),女,南京中医药大学硕士研究生,研究方向为肿瘤临床。E-mail:964559061@qq.com;通讯作者:方志军(1965-),男,南京中医药大学附属中西医结合医院主任医师,博士生导师,研究方向为肿瘤临床及名中医学术经验挖掘。E-mail:1248256089@qq.com
