天津市天津医院/天津大学医学院,天津市河西区解放南路406号,300211
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收稿:2024-04-30,
修回:2024-11-11,
纸质出版:2025-05-02
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李梦宜,张磊,王立军等.西黄丸/胶囊辅助放疗和(或)化疗治疗消化道恶性肿瘤有效性和安全性的Meta分析[J].中医杂志,2025,66(09):912-919.
LI Mengyi, ZHANG Lei, WANG Lijun, et al. A Meta-Analysis on the Efficacy and Safety of Xihuang Pill/Capsule( 西黄丸/胶囊) as an Adjuvant to Radio⁃therapy and Chemotherapy in the Treatment of Malignant Digestive Tract Tumors[J]. Journal of Traditional Chinese Medicine, 2025, 66(9): 912-919.
李梦宜,张磊,王立军等.西黄丸/胶囊辅助放疗和(或)化疗治疗消化道恶性肿瘤有效性和安全性的Meta分析[J].中医杂志,2025,66(09):912-919. DOI: 10.13288/j.11-2166/r.2025.09.008.
LI Mengyi, ZHANG Lei, WANG Lijun, et al. A Meta-Analysis on the Efficacy and Safety of Xihuang Pill/Capsule( 西黄丸/胶囊) as an Adjuvant to Radio⁃therapy and Chemotherapy in the Treatment of Malignant Digestive Tract Tumors[J]. Journal of Traditional Chinese Medicine, 2025, 66(9): 912-919. DOI: 10.13288/j.11-2166/r.2025.09.008.
目的
2
评价西黄丸/胶囊在临床辅助放疗和(或)化疗治疗消化道恶性肿瘤的有效性及安全性。
方法
2
检索中国生物医学文献数据库、中国知网、万方数据知识服务平台、维普数据库、PubMed、Web of science、Embase、Cochrane Library自建库至2024年3月6日期间发表的有关西黄丸/胶囊在临床辅助治疗消化道恶性肿瘤的随机对照试验,采用偏倚风险评估标准评价纳入文献的方法学质量,应用RevMan 5.4对一年生存率和二年生存率、临床疗效(包括客观缓解率、疾病控制率)、卡诺夫斯凯(KPS)评分、免疫指标(CD3
+
、CD4
+
、CD8
+
及CD4
+
/CD8
+
)和不良反应发生率(包括胃肠道反应、骨髓抑制)进行Meta分析。
结果
2
共纳入13项随机对照试验,共962例患者,其中试验组527例,对照组435例。Meta分析结果显示,试验组在二年生存率[
RR
=0.49,95%
CI
(0.31,0.78)]、客观缓解率[
RR
=0.68,95%
CI
(0.60,0.77)]、疾病控制率[
RR
=0.85,95%
CI
(0.80,0.91)]以及免疫指标CD3
+
[
MD
=-7.99,95%
CI
(-9.12,-6.86)]、CD4
+
[
MD
=-5.42,95%
CI
(-7.11,-3.74)]、CD4
+
/CD8
+
[
MD
=-0.26,95%
CI
(-0.32,-0.20)]方面均优于对照组(
P
<0.05)。试验组与对照组在一年生存率[
RR
=0.91,95%
CI
(0.73,1.14)]、KPS评分[
MD
=-3.73,95%
CI
(-8.67,1.21)]、CD8
+
[
MD
=-0.53,
95%CI
(-1.45,0.39)]、胃肠道反应发生率[
RR
=0.82,
95%CI
(0.46,1.46)]、骨髓抑制发生率[
RR
=0.93,
95%CI
(0.72,1.20)]比较差异均无统计学意义(
P
>0.05)。
结论
2
与单纯使用放疗和(或)化疗相比,消化道恶性肿瘤患者在给予放疗和(或)化疗的同时联用西黄丸/西黄胶囊可以有效提高临床疗效、二年生存率,改善免疫指标,在不良反应方面与单纯使用放疗和(或)化疗相当。
Objective
2
To evaluate the efficacy and safety of
Xihuang Pill/Capsule
(西黄丸/胶囊, XP/XC) as an adjuvant to radiotherapy and/or chemotherapy in the treatment of malignant digestive tract tumors.
Methods
2
A systematic search was
conducted in the China Biomedical Literature Database, China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, VIP Database, PubMed, Web of Science, Embase, and Cochrane Library for randomized controlled trials (RCTs) published before March 6, 2024, regarding the use of XP/XC in clinical adjuvant treatment of malignant digestive tract tumors. The methodological quality of the included studies was assessed using the risk of bias assessment tool. RevMan 5.4 was used to perform a Meta-analysis on 1-year survival rate, 2-year survival rate, clinical efficacy, including objective response rate and disease control rate, Karnofsky Performance Status (KPS) score, immune markers (CD3
+
, CD4
+
, CD8
+
, and CD4
+
/CD8
+
ratio), and adverse event rates (incidence of gastrointestinal reactions and bone marrow suppression).
Results
2
Thirteen RCTs involving 962 patients were included, with 527 patients in the experimental group and 435 patients in the control group. Meta-analysis results showed that the experimental group had better outcomes than the control group in terms of 2-year survival rate [
RR
= 0.49, 95%
CI
(0.31, 0.78)], objective response rate [
RR
= 0.68, 95%
CI
(0.60, 0.77)], disease control rate [
RR
= 0.85, 95%
CI
(0.80, 0.91)], and immune markers CD3
+
[
MD
= -7.99, 95%
CI
(-9.12, -6.86)], CD4
+
[
MD
= -5.42, 95%
CI
(-7.11, -3.74)], and CD4
+
/CD8
+
ratio [
MD
= -0.26, 95%
CI
(-0.32, -0.20)] (
P
<0.05). However, no statistically significant differences were found between the experimental and control groups in terms of 1-year survival rate [
RR
= 0.91, 95%
CI
(0.73, 1.14)], KPS [
MD
= -3.73, 95%
CI
(-8.67, 1.21)], CD8
+
[
MD
= -0.53, 95%
CI
(-1.45, 0.39)], incidence of gastrointestinal reactions [
RR
= 0.82, 95%
CI
(0.46, 1.46)], and incidence of bone marrow suppression [
RR
= 0.93, 95%
CI
(0.72, 1.20)] (
P
>0.05).
Conclusion
2
Compared with radiotherapy/chemotherapy alone, the combination of XP/XC with radiotherapy/chemotherapy can effectively improve clinical efficacy and 2-year survival rate, enhance immune function, and achieve similar adverse event rates as radiotherapy/chemotherapy alone in patients with malignant digestive tract tumors.
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