[目的]评价中医药联合肝动脉化疗栓塞术（transcatheter arterial chemoembolization, TACE）在中晚期原发性肝癌（primary liver cancer, PLC）治疗中的疗效。[方法]全面检索从1994年1月1日至2014年7月1日关于中医药联合TACE治疗中晚期PLC的临床试验文献，采用单纯TACE作为对照组，采用中医药联合TACE作为治疗组并随机对照试验进行Meta分析。[结果]纳入10项研究，776例PLC，对照组和治疗组的例数分别为373例和403例。Meta分析结果显示：治疗组显著提高1年、2年生存率及近期疗效，改善体力状况，具有统计学意义，但0．5年生存率两者无显著性差异。同时在减轻TACE术治疗引起的骨髓抑制方面，治疗组能够降低白细胞减少的发生并且具有显著性差异，但对血小板减少发生率及血红蛋白减少发生率的影响不明显。[结论]中医药联合TACE的治疗组对治疗中晚期PLC的疗效优于单纯TACE的对照组，但是由于文献的方法学质量较低，仍需要大样本、多中心、高质量的临床研究试验验证。%Objective] To evaluate the effectiveness of TCM combined with TACE in treatment for middle-advanced primary liver cancer. [Methods] Generally retrieved clinical literatures of TCM combined with TACE in treatment for middle-advanced primary liver cancer from January 1th 1994 to July 1th 2014, conducted TACE alone as control group and TCM combined with TACE as treatment group, and had a comparison by Meta-analysis. [Results] Ten clinical trials with 776 middle-advanced primary liver cancer patients were included. 373 patients were in the control group, and 403 patients were in the treatment group. Meta-analysis indicated that treatment group was superior to control group in increasing one year survival rate and two years survival rate, short-term curative effects, and improving performance status, showing statistically significant differences, while the difference of half a year survival rate was not statistically significant between the two groups. In terms of myelo-suppression generated by TACE, the occurrence of WBC in decreasing was reduced; the difference was statistically significant, while the differences of reducing the occurrence of PLT and HGB in decreasing were not statistically significant. [Conclusion] The curative effect of treatment group is superior to the control group. However, due to the low methodological quality of the literature, it still needs large sample, multi-center, high-quality clinical research trials to continue to validate.
展开▼
