Clinical RCT Of Hepatic Artery Chemoembolization Combined With Liver-soothing And Spleen-invigorating Therapy For Primary Carcinoma Of Liver:Meta-analysis

Objective:Through the reseach of transcatheter arterial chemoembolization(TACE)combined with Soothing the liver and strengthening the spleen therapy for primary liver cancer clinical RCT literature,the treatment efficiency,the patient’s quality of life change rate,1-year survival rate,toxicity analyze and evaluate the response to provide a basis for clinical application.Methods:Randomized controlled trials(RCT)of TACE combined with Liver-soothing and spleen-invigorating therapy for primary liver cancer were collected by searching CNKI,Wanfang,Weipu,PUBMED and Embase databases.According to the inclusion criteria and exclusion criteria,the literature was selected and the methodological quality was evaluated.Finally,the literature data were extracted according to the observation indicators and imported into RevMan 5.3 software for meta-analysis.Results:A total of 24 randomized controlled trials including 1760 patients were included.Meta analysis showed that the observation group had advantages in objective effective rate [RR = 1.31,95% CI(1.16,1.49),P <0.0001],TCM syndrome improvement rate [RR=1.37,95% CI(1.22,1.53),P<0.00001],quality of life improvement rate [RR=1.94,95% CI(1.54,2.43),P<0.00001],1-year survival Rate [RR=1.38,95% CI(1.21,1.57),P<0.00001],liver function ALT [MD=-11.33,95% CI(-16.53,-6.12),P<0.0001],immune index CD4+[ MD=7.53,95% CI(1.54,13.53),P=0.01],CD4+/CD8+ [MD=0.33,95% CI(0.08,0.59),P=0.01] and decreased AFP [MD=-34.14,95% CI(-56.94,-11.33),P=0.003],incidence of myelosuppression [RR=0.58,95% CI(0.45,0.77),P<0.0001],pain incidence rate [RR=0.75,95% CI(0.60),0.94),P = 0.01],incidence of fatigue [RR = 0.47,95% CI(0.25,0.90),P = 0.02],incidence of nausea and vomiting [RR = 0.75,95% CI(0.59,0.96),P =0.02],the incidence of fever [RR = 0.73,95% CI(0.63,0.85),P <0.0001] has a clear advantage over TACE treatment alone.However,in the case of liver function TBIL [MD=-1.48,95% CI(-4.57,1.60),P=0.34],immune index CD8+ [MD=-1.16,95% CI(-2.95,0.63),P=0.20],the TACE combination therapy regimen has no significant advantage over the TACE regimen alone.Conclusion:TACE combined with Liver-soothing and spleen-invigorating therapy for primary hepatocellular carcinoma can significantly improve the objective efficiency,improving TCM syndrome,increasing one-year survival rate and quality of life,immune function,significantly reduce ALT,AFP,bone marrow suppression,pain,fatigue,nausea and vomiting,fever.However,the combined treatment group had no obvious advantage in reducing TBIL.