Traditional Chinese Medicines in the treatment of hepatocellular cancers: a systematic review and meta-analysis.
Traditional Chinese Medicines in the treatment of hepatocellular cancers: a systematic review and meta-analysis.
复制标题
DOI：
10.1186/1756-9966-28-112
复制
发表时间：
2009-08-12
期刊：
影响因子：
--
通讯作者：
Mills EJ
中科院分区：
文献类型：
--
作者：
Wu P;Dugoua JJ;Eyawo O;Mills EJ
肝癌是一种常见的恶性肿瘤，死亡率很高。鉴于与这种癌症相关的不良预后，许多患者寻求可能改善生活质量或生存的额外疗法。几种中药（TCM）已在临床试验中进行了评估，但在中国以外的地区对其知之甚少。截至 2009 年 2 月，我们独立并重复检索了 8 个电子数据库，其中包括 2 个中文数据库。我们纳入了任何评估中药口服制剂治疗肝细胞癌的随机临床试验 (RCT)。我们提取了生存率、肿瘤反应和表现评分的数据。我们进行了随机效应荟萃分析并应用了荟萃回归分析。我们纳入了 45 项随机对照试验 (n = 3,236)。所有研究均采用活性对照组。总体而言，对方法问题的报告很差。我们分析了 37 项报告完全缓解效果评分的试验的数据（相对风险 [RR] 为 1.26（95 CI，1.04–1.52，P = 0.01，I2 = 0%，P = 0.99）。含有人参、黄芪和斑蝥的产品具有更大的治疗效果（OR 1.34，95% CI，1.04–1.71，P = 0.01）高于汇总的广泛估计，基于黄芪的治疗也是如此（OR 1.35，95% CI，1.001–1.80。P = 0.048）。我们检查了生存率并汇总了报告 6 个月结果的 15 项研究（RR 1.10，95% CI，1.04–1.15，P = < 0.0001，I2 =这种效应在其他前瞻性日期中是一致的，包括 12 个月（22 项试验，RR 1.26，95% CI，1.17–1.36，P = < 0.0001，I2 = 7%，P = 0.36）、24 个月（15 项试验，1.72，95% CI，1.40–2.03，P = < 0.0001，I2 = 0%，P = 0.75）；并且，在 36 个月时（8 项试验，RR 2.40，95% CI，1.65-3.49，P = < 0.0001，I2 = 0%，P = 0.62）。我们的荟萃分析显示了对肝细胞癌有效性的令人信服的证据，应在高质量和透明的临床试验中进行评估。
Liver cancer is a common malignancy with a high mortality rate. Given the poor prognosis associated with this cancer, many patients seek additional therapies that may improve quality of life or survival. Several Traditional Chinese Medicines (TCM) have been evaluated in clinical trials, but little is known about them outside of China. We searched independently and in duplicate 8 electronic databases, including 2 Chinese language databases, until February 2009. We included any randomized clinical trials (RCT) evaluating a TCM oral preparation for the treatment of hepatocellular cancers. We abstracted data on survival, tumor response, and performance scores. We conducted a random-effects meta-analysis and applied a meta-regression analysis. We included 45 RCTs (n = 3,236). All studies employed an active control group. In general, the reporting of methodological issues was poor. We analyzed data from 37 trials reporting on complete response effects score (Relative Risk [RR] of 1.26 (95 CI, 1.04–1.52, P = 0.01, I2 = 0%, P = 0.99). Products containing ginseng, astragalus and mylabris had a larger treatment effect (OR 1.34, 95% CI, 1.04–1.71, P = 0.01) than the pooled broad estimate, also the case for astragalus-based treatments (OR 1.35, 95% CI, 1.001–1.80. P = 0.048). We examined survival rates and pooled 15 studies reporting on 6 month outcomes (RR 1.10, 95% CI, 1.04–1.15, P = < 0.0001, I2 = 0%, P = 0.60). This effect was consistent at other prospective dates, including 12 months (22 trials, RR 1.26, 95% CI, 1.17–1.36, P = < 0.0001, I2 = 7%, P = 0.36), 24 months (15 trials, 1.72, 95% CI, 1.40–2.03, P = < 0.0001, I2 = 0%, P = 0.75); and, at 36 months (8 trials, RR 2.40, 95% CI, 1.65–3.49, P = < 0.0001, I2 = 0%, P = 0.62). All included trials were conducted in China where emerging evidence suggests many RCTs are not, in fact, randomized. Publication bias may exist, favouring positive reports. Our meta-analysis displays compelling evidence of effectiveness for hepatocellular cancers that should be evaluated in high-quality and transparent clinical trials.
登录
查看更多内容
影响因子：
6.1
作者：
Huh, JE;Kang, KS;Kim, SH
通讯作者：
Kim, SH
影响因子：
2
作者：
Higgins, JPT;Thompson, SG
通讯作者：
Thompson, SG
影响因子：
29.4
作者：
Bosch, FX;Ribes, J;Cléries, R
通讯作者：
Cléries, R
影响因子：
2.3
作者：
Fleiss, J L
通讯作者：
Fleiss, J L
DOI：
10.1111/j.1349-7006.1994.tb02408.x
发表时间：
1994-06-01
期刊：
JAPANESE JOURNAL OF CANCER RESEARCH
影响因子：
--
作者：
JING, YK;OHIZUMI, H;NAKAYA, K
通讯作者：
NAKAYA, K