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目的:评价中草药联合化疗治疗晚期大肠癌的临床研究的研究质量及疗效、生存质量、安全性。方法:通过计算机检索有关中草药联合化疗治疗晚期大肠癌的临床研究文献,检索数据库包括CNKI知识资源总库、维普数据库、万方数据库,检索限定时间为2003—2013年,采用Cochrane协作网提供的Rev Man5.0软件进行Meta分析。结果:共检索得到符合要求的文献23篇,研究质量Jadad评分在1~4分之间,均属低质量研究。对近期疗效、卡式评分、白细胞下降率进行Meta分析,OR值和95%可信区间分别为1.57[1.21~2.05]、3.99[2.98~5.34]、0.43[0.29~0.64]。结论:中草药联合化疗可提高晚期大肠癌患者的生活质量,减轻毒副反应,但研究的方法学质量偏低,尚不能作为可靠的临床应用证据,期待设计更合理、方法更科学、样本量更大、多中心的随机双盲对照临床试验,为中草药推广到临床提供更为可靠的证据。
OBJECTIVE: To evaluate the quality, efficacy, quality of life and safety of clinical studies of Chinese herbal medicine combined with chemotherapy for advanced colorectal cancer. Methods: The clinical research literature on Chinese herbal medicine combined with chemotherapy for advanced colorectal cancer was searched by computer. The retrieval database included CNKI knowledge base, VIP database and Wanfang database. The retrieval limit was from 2003 to 2013, and the Cochrane Collaboration provided Rev Man5.0 software for meta-analysis. Results: A total of 23 satisfactory articles were retrieved and the Jadad score of the study was between 1 and 4, all of which were of low quality. The curative effect, card score and leukopenia rate were analyzed by meta-analysis. The OR and 95% confidence intervals were 1.57 [1.21-2.05], 3.99 [2.98-5.34] and 0.43 [0.29-0.64], respectively. Conclusion: Chinese herbal medicine combined with chemotherapy can improve the quality of life of patients with advanced colorectal cancer, reduce the side effects, but the methodological quality of the study is low, it can not be used as a reliable clinical evidence, looking forward to a more rational design, more scientific method, sample size more Large, multicenter, randomized, double-blind controlled clinical trial provides more reliable evidence for the promotion of Chinese herbal medicine to the clinic.