A Network Meta-analysis Of Tonifying Traditional Chinese Medicine Injection In The Prevention And Treatment Of Cardiotoxicity Induced By Anthracycline Chemotherapy In Breast Cancer

Objective: The traditional meta-analysis was used to systematically evaluate the effectiveness of tonifying traditional Chinese medicine injec-tion in the prevention and treatment of cardiotoxicity caused by anthracycline chemotherapy in breast cancer;Based on the network metaanaly-sis,the differences in the clinical efficacy of different tonifying traditio-nal Chinese medicine injections in the prevention and treatment of cardiotoxicity caused by anthracycline chemotherapy in breast cancer were compared,so as to screen the relatively optimal intervention scheme under each outcome index,in order to provide reference and evidence based basis for subsequent research,clinical diagnosis and treatment.Methods: A randomized controlled trial on the prevention and treatment of cardiotoxicity caused by anthracycline chemotherapy for breast cancer was conducted by using computer assisted manual retrieval to retrieve CNKI,Wanfang database,VIP database,Pub Med and Cochrane Library from the establishment of the database to December 31,2022.Select literature and extract data according to inclusion and exclusion criteria.The Cochrane bias risk assessment tool was used to evaluate the quality and bias risk of the literature included in the study.Use Review Manager 5.3 software to conduct traditional meta-analysis.Use Stata 16.0 software for network meta-analysis.Results:A total of 17 articles,8 kinds of traditional Chinese medicine injections and 1538 patients were included.1.The results of traditional meta-analysis:The effect of tonifying traditional Chinese medicine injection group was significantly better than that of the blank control group in reducing the incidence of ECG abnormalities,cardiac dysfunction and c Tn I increase caused by anthracycline chemotherapy,and in improving the LVEF reduction caused by anthracycline chemotherapy,the difference was statistically significant.Compared with the blank control group,the effect of reducing the increase of CK-MB caused by anthracycline chemotherapy was not significant,and the difference was not statistically significant.2.The results of network meta-analysis:(1)In terms of reducing the incidence of ECG abnormalities after anthracycline chemotherapy,the order of efficacy according to the value of SUCRA is Shenmai injection >Gaolishen injection > Kangai injection > Shenqi Fuzheng injection >Shengmai injection > blank control.(2)In terms of reducing the incidence of cardiac dysfunction after anthracycline chemotherapy,the order of efficacy according to the value of SUCRA is Aidi injection > Shenmai injection >Shenfu injection > Shenqi Fuzheng injection > blank control.(3)In terms of improving the reduction of LVEF after anthracycline chemotherapy,the order of efficacy according to the value of SUCRA is Shenfu Injection > Shenqi Fuzheng Injection > Xinmailong Injection > Shengmai Injection > Shenmai Injection > blank control.(4)In terms of reducing the increase of c Tn I after anthracycline chemotherapy,the order of efficacy according to the value of SUCRA is Xinmailong injection > Shengmai injection > blank control.(5)In terms of reducing the increase of CK-MB after anthracycline chemotherapy,the order of efficacy according to the value of SUCRA is Aidi injection > Shengmai injection > blank control.Conclusion(s): 1.The results of traditional meta-analysis: Tonifying traditional Chinese medicine injection has a certain effect on the prevention and treatment of cardiotoxicity caused by anthracycline chemotherapy in patients with breast cancer.2.The results of network meta-analysis: Shenmai injection may be the relatively optimal intervention measure to reduce the incidence of electrocardiogram abnormalities;Aidi injection may be the relatively optimal intervention measure to reduce the incidence of cardiac dysfunction and reduce CK-MB;Shenfu injection may be the relatively optimal intervention to increase LVEF;Xinmailong injection may be the relatively optimal intervention to reduce c Tn I.