Effect Of Traditional Chinese Medicine On Quality Of Life In Patients With Cervical Cancer After Chemoradiotherapy:A Meta Analysis

Objective: The statistical method of Meta-analysis was used to evaluate the impact of traditional Chinese medicine on the quality of life of cervical cancer patients with synchronous chemoradiotherapy,in order to provide a real and reliable evidence-based medical basis.Method: By using the method of evidence-based medicine,we searched the relevant databases manually including CNKI,WF,VIP,CBM,Pub Med,Embase and Cochrane library.The retrieval time is from the establishment of the database to 2022.Objective to standardize the search process,and finally select the relevant randomized controlled trials(RCT)clinical research literatures about the quality of life of oral traditional Chinese medicine was used to intervene in cervical cancer patients after concurrent chemoradiotherapy.Revaman5.3 software was used to assess the risk of bias in the literature,Meta-analysis of relevant outcome measures,and heterogeneity test,sensitivity analysis,subgroup analysis and publication bias assessment.Result:1 A total of 24 articles were included in this study,all of which were in Chinese.There were 2408 patients in all incorporated in this study,including 1206 in the experimental group and 1204 in the control group.The results of bias risk assessment showed that all literature had different degrees of bias.2 Meta-analysis results: Cervical cancer patients after concurrent chemoradiotherapy combined with Chinese medicine intervention,in the treatment of quality of life-related indicators such as KPS score improvement rate [OR=3.87,95%CI(2.92,5.12),Z=9.43(P <0.00001)],the KPS score [MD =12.15,95%CI(4.51,19.79),Z=3.12(P=0.002<0.005)],SF-36 scale score [MD =6.68,95%CI(-0.29,13.64),Z=1.88(P=0.06)],QOL scale score [MD =13.92,95%CI(12.07,15.76),Z=14.77(P< 0.00001)];Efficacy indicators such as the objective remission rate(ORR)[OR=2.89,95%CI(2.22,3.78),Z=7.82(P <0.00001)],disease control rate(DCR)[O R=3.71,95%CI(2.35,5.86),Z=5.63(P<0.00001)],active efficiency [OR=8.88,95%CI(3.70,14.37),Z=5.73(P<0.00001)];The CD3 + cells level of increasing immune level [MD=9.53,95%CI(5.71,13.35),Z=4.89(P<0.00001)],CD4 + cell levels [MD=9.71,95%CI(5.58,13.85),Z=4.61(P<0.00001)],CD4 + / CD8 + ratio [MD=0.47,95%CI(0.30,0.65),Z=5.42(P<0.00001)],NK cell levels [MD=1.42,95%CI(1.14,1.71),Z=9.94(P<0.00001)] was better than the control group;And can significantly reduce the incidence of gastrointestinal reaction,radiation enteritis,radiation cystitis,bone marrow suppression,hair loss,allergy,Significantly reduced the occurrence of white blood cells,hemoglobin,platelets,and neutropenia,Reduce the incidence of liver and renal function impairment,Improve the level of patient safety index after concurrent radiotherapy and chemotherapy;While in the incidence of diarrhea [OR =1.07,95%CI(0.36,3.22,Z=0.13(P=0.90)],CD8 + cell level [MD=-1.32,95%CI(-4.09,1.44),MD,<0,Z=0.94(P=0.35)] In efficacy,There was no significant difference from the control group.3 Sensitivity analysis was performed for all results,where suboptimal Meta-analysis with CD8 + cell levels was not robust.Publication bias results showed less publication bias of KPS score,ORR,and DCR.Conclusion:1 The treatment improvement of cervical cancer patients may be better than the control group in enhance the quality of life score,objective remission rate,disease control rate,symptom improvement rate,immune function level,safety indicators,and reducing the incidence of adverse effects.2 Compared with the rising leukocyte treatment group,the cervical cancer patients may have no obvious advantage in improving the incidence of nausea and vomiting.3 Compared with the control group,TCM intervention with concurrent chemoradiotherapy with no obvious advantages in improving the CD8 + level,reducing the incidence of diarrhea.