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目的:系统评价化疗联合健脾中药与单纯化疗治疗比较大肠癌患者疗效、生活质量及生存率。方法:检索中国生物医学文献光盘数据库、中国期刊全文数据库、万方数据医药信息系统,选择1990—2013年4月公开发表的有关健脾方药联合西药化疗治疗大肠癌的相关文献,运用Cochrane协作网提供的RevMan5.1软件分析,以OR值作为效应指标,主要对实体瘤疗效总有效率(CR+PR)、KPS评分、生存率进行观察,计算中西医结合治疗对单纯化疗治疗的优势。结果:治疗组瘤体疗效总有效率(CR+PR)优于对照组,差异有统计学意义(OR=2.01,95%CI=1.11~3.65,P<0.05),治疗组KPS评分优于对照组,差异有统计学意义(WMD=8.44,95%CI=5.96~10.92,P<0.05),治疗组1、2、3年生存率均优于对照组,差异有统计学意义(OR=3.13、2.35、3.16,95%CI=1.88~5.19、1.49~3.70、1.93~5.18,P<0.05)。结论:中西医结合治疗大肠癌的疗效优于单纯西药,但纳入研究质量均为低质量,导致发表存在偏倚,需要高质量研究做进一步验证。
OBJECTIVE: To evaluate the efficacy, quality of life and survival rate of patients with colorectal cancer by systematic evaluation of chemotherapy combined with spleen-strengthening traditional Chinese medicine and chemotherapy alone. Methods: To search for relevant literature on Chinese medicine for treating colorectal cancer treated with combination of Chinese herbal medicine and traditional Chinese medicine in the period of 1990 - 2013 published in China CDM database, Chinese periodical full-text database and Wanfang data medical information system. Cochrane Collaboration RevMan5.1 software analysis provided, OR value as the effect index, the main effect of the total effective rate of solid tumors (CR + PR), KPS score, survival rate were observed, the treatment of traditional Chinese and Western medicine treatment of chemotherapy alone advantages. Results: The total response rate (CR + PR) in the treatment group was better than that in the control group (OR = 2.01, 95% CI = 1.11-3.65, P <0.05) The difference was statistically significant (WMD = 8.44, 95% CI = 5.96-10.92, P <0.05). The 1, 2, 3 year survival rate of the treatment group was better than that of the control group (OR = 3.13 , 2.35,3.16,95% CI = 1.88 ~ 5.19,1.49 ~ 3.70,1.93 ~ 5.18, P <0.05). Conclusion: The curative effect of integrated traditional Chinese and western medicine on colorectal cancer is better than that of western medicine alone. However, the quality of the included studies is low, which leads to the existence of bias and the need of high quality research for further verification.