CAJ | 학술논문

目的：评价中药配合放疗治疗中晚期肝细胞癌（ HCC ）的有效性和安全性。方法计算机检索中国期刊全文数据库、中文科技期刊全文数据库、万方数据库、中国生物医学文献数据库、Cochrane图书馆、PubMed、Embase，纳入有关中药配合放疗治疗中晚期HCC的随机对照试验和队列研究，参照Cochrane 手册5．1．0版的文献质量评价标准评估纳入研究的质量，并通过RevMan 5．2软件进行统计分析。结果共纳入15个随机对照试验和5个队列研究，共1475例患者。Meta分析结果显示：中药配合放疗治疗中晚期HCC在近期疗效[RR＝1．32，95％CI（1．15，1．50），P＜0．001]和1、2、3年生存率[RR＝1．28，95％CI（1．13，1．44），P＜0．001；RR ＝1．33，95％ CI（1．08，1．63），P ＝0．007；RR ＝1．65，95％CI （1．14，2．37），P＝0．007]方面优于单纯放疗；中药配合放疗治疗中晚期 HCC 的血液学毒性反应发生率和放射性肝损伤发生率也显著低于单纯放疗（P均＜0．001）。结论中药配合放疗治疗中晚期HCC，可以提高放疗的近期疗效，延长患者的生存期，并且能减少放疗的毒副作用。但由于纳入研究的质量不高，尚需多中心、大样本、高质量的临床试验来进一步验证。
목적：평개중약배합방료치료중만기간세포암（ HCC ）적유효성화안전성。방법계산궤검색중국기간전문수거고、중문과기기간전문수거고、만방수거고、중국생물의학문헌수거고、Cochrane도서관、PubMed、Embase，납입유관중약배합방료치료중만기HCC적수궤대조시험화대렬연구，삼조Cochrane 수책5．1．0판적문헌질량평개표준평고납입연구적질량，병통과RevMan 5．2연건진행통계분석。결과공납입15개수궤대조시험화5개대렬연구，공1475례환자。Meta분석결과현시：중약배합방료치료중만기HCC재근기료효[RR＝1．32，95％CI（1．15，1．50），P＜0．001]화1、2、3년생존솔[RR＝1．28，95％CI（1．13，1．44），P＜0．001；RR ＝1．33，95％ CI（1．08，1．63），P ＝0．007；RR ＝1．65，95％CI （1．14，2．37），P＝0．007]방면우우단순방료；중약배합방료치료중만기 HCC 적혈액학독성반응발생솔화방사성간손상발생솔야현저저우단순방료（P균＜0．001）。결론중약배합방료치료중만기HCC，가이제고방료적근기료효，연장환자적생존기，병차능감소방료적독부작용。단유우납입연구적질량불고，상수다중심、대양본、고질량적림상시험래진일보험증。
Objective To evaluate the efficacy and safety of traditional Chinese medicine ( TCM) combined with radiotherapy for the treatment of intermediate and advanced stage hepatocellular carcinoma ( HCC) .Methods The databases of computer retrieve included CNKI,VIP,Wanfang Database,CBM Disc,Cochrane Library,PubMed and Embase.And randomized controlled trials(RCTs) and cohort studies about TCM combined with radiotherapy for the treatment of intermediate and advanced stage HCC were collected .The quality assessment of included studies was performed based on the literature quality assessment criteria recommended by the Cochrane handbook (ver.5.1.0),and a statistical analysis was conducted using RevMan 5.2 software.Results Fifteen RCts and five cohort studies were involved,which consisted of 1475 patients.Meta-analysis revealed that the short-term efficacy(RR=1.32,95%CI(1.15,1.50),P<0.001) as well as the 1-,2-and 3-year survival rates(RR=1.28,95%CI(1.13,1.44),P<0.001;RR=1.33,95%CI(1.08,1.63),P=0.007;RR=1.65,95%CI(1.14,2.37),P=0.007,respectively) in patients treated with TCM combined with radiotherapy was significantly superior for intermediate and advanced stage HCC compared with patients treated with radiotherapy alone .Compared with patients treated with radiotherapy alone,patients treated with TCM combined with radiotherapy had significantly lower incidences of hematological toxic reaction and radiation-induced liver injury for intermediate and advanced stage HCC (all P<0.001).Conclusion TCM combined with radiotherapy can improve short-term efficacy of radiotherapy ,prolong survival time and reduce the incidence of radiotherapy-related toxic and adverse reactions for patients with intermediate and advanced stage HCC .The qualities of included studies are not high ,therefore ,more multi-center,large-sample and high-quality clinical trials are needed to further confirm this conclusion .