Meta-analysis Of The Efficacy Of Integrated Traditional Chinese And Western Medicine In The Treatment Of Radiation Proctitis

BACKGROUND & OBJECTIVE: Radiation proctitis(RP)is one of the most common complications of many pelvic malignancies,such as rectal cancer,cervical cancer,prostate cancer,or during radiotherapy or after radiotherapy.It brings inconvenience and pain to the patient’s life,affects the continuity of radiotherapy,and prolongs or interrupts the radiotherapy treatment,thus affecting the therapeutic effect.It is often manifested as diarrhea,abdominal pain,blood in the stool and mucous bloody stools.In severe cases,intestinal obstruction and intestinal perforation occur.The incidence rate is 6% to 17%.Most of the patients are prolonged and unhealed,which seriously affects the prognosis and quality of life of patients.With the increasing role of radiotherapy in the treatment of such tumors,it is foreseeable that the incidence of radiation proctitis may be further increased in the future [1].At present,there are many methods for treating radiation proctitis.There is still no ideal medicine and treatment method for western medicine treatment.Western medicine mostly uses surgery and nutritional support therapy.The adverse reactions are high and the recurrence rate is high,and Chinese medicine has shown safety in its treatment.Convenient and efficient advantages.In recent years,with the gradual development of traditional Chinese medicine,its unique curative effect has been accepted by the world.The research on traditional Chinese medicine for radiation proctitis has developed rapidly,and some important achievements have been made from basic research to clinical practice.The internal treatment of TCM and the external treatment are now widely valued by medical workers,especially the application of traditional Chinese medicine enema,acupuncture and auricular acupoints in the treatment of radiation proctitis.The curative effect is remarkable and the advantages are obvious.After decades of difficult development,the combination of traditional Chinese and Western medicine has been accepted by the world.However,it has been found that there are many kinds of treatments and methods for the treatment of radiation proctitis in Chinese medicine,but there is no uniform and fixed standard,and the cases included in each study are relative.Less,lack of multi-center,large-sample prospective studies,it is difficult to objectively and scientifically evaluate its efficacy.Therefore,this study used the meta-analysis method to evaluate the clinical efficacy and safety of integrated Chinese and Western medicine in the treatment of radiation proctitis.At the same time,the choice of clinical treatment plan provides a corresponding basis.METHODS:The computer retrieves databases such as CNKI,China Biomedical Literature Database(CBM/SinoMed),VIP Chinese Journal Database(VIP),Wanfang,PubMed database,Cochrane database,and Embase database.The search time is from January 2002 to December 2017,and the language is limited to Chinese and English.Comprehensively search for clinical studies published at home and abroad using the combination of traditional Chinese and Western medicine to treat radiation proctitis.The type of study required to be included in the literature must be a randomized controlled trial(RCT).All the literatures were selected by two panelists according to the inclusion and exclusion criteria,and the final inclusion of the literature was selected.The above literature data were extracted and summarized,and the results were obtained by statistical analysis using RevMan5.3 software provided by Cochrane Collaboration.RESULTS:A total of 17 studies were included.Meta-analysis found that the total effective rate of OR [95% CI] was 5.13 [3.78,6.96],(P < 0.00001);two studies compared the KPS scores after treatment in the two groups [2] improved.Situation: OR [95% CI] was 14.8 [10.78,18.84];4 studies compared TCM symptom scores after intervention in both groups [3] Improvement: TCM symptom score change: abdominal pain-0.66 [-0.83,-0.5],blood in the stool-0.53 [-0.68,-0.38],after the emergency,heavy-0.63 [-0.77,-0.49].Conclusion: Compared with western medical treatment,integrated Chinese and Western medicine therapy has advantages in high total efficiency,less adverse reactions and improved quality of life.