Network Meta-analysis Of Four Health-Strengthening And Qi-Nourishing Chinese Herb Injections Combined With Chemotherapy For Breast Cancer

Objective:To analyze and evaluate the effectiveness and safety of four kinds of health-strengthening and qi-nourishing Chinese herb injections combined with chemotherapy in the treatment of breast cancer using the method of network meta-analysis.And to sort out the best intervention plan,so as to provide evidence for clinical practice.Methods:Databases including Pub Med,Embase,Cochrane Library,Web of Science,CBM,CNKI,Wan Fang Database,VIP were retrieved to collect the randomized controlled trials about the four injections included Astragalus injection,Kang'ai injection,Aidi injection,and Shenqi Fuzheng injection combined with chemotherapy in the treatment of breast cancer.Set inclusion and exclusion criteria to screen out documents,and then evaluate the quality of these documents.Finally we have come to the conclusion that which injection was the optimal one under each outcome index by the use of Stata 15.0.Results:The study included 66 clinical randomized controlled trials involving 4,124 breast cancer patients.The results of network meta-analysis are as follows:(1)The network meta-analysisbased on Total effective rate showed from high to low as follows: Astragalus injection combined with chemotherapy(SUCRA=77.0%),Shenqi Fuzheng injection combined with chemotherapy(SUCRA=71.3%),Kang'ai injection combined with chemotherapy(SUCRA=60.6%),Aidi injection combined with chemotherapy(SUCRA=41.1%).(2)The ranking in terms of quality of life improvement rate showed as follows: Aidi injection combined with chemotherapy(SUCRA=83.4%),Kang'ai injection combined with chemotherapy(SUCRA=64.9%),Shenqi Fuzheng injection combined with chemotherapy(SUCRA=54.2%),Astragalus injection combined with chemotherapy(SUCRA=46.3%).(3)The ranking in reducing the incidence of gastrointestinal adverse reactions: Astragalus injection combined with chemotherapy(SUCRA=88.7%),Shenqi Fuzheng injection combined with chemotherapy(SUCRA=71.3%),Aidi injection combined with chemotherapy(SUCRA=57.2%),Kang'ai injection combined with chemotherapy(SUCRA=32.7%).(4)In terms of relieving the decrease of white blood cells: Kang'ai injection combined with chemotherapy(SUCRA=75.3%),Astragalus injection combined with chemotherapy(SUCRA=74.0%),Aidi injection combined with chemotherapy(SUCRA=61.4%),Shenqi Fuzheng injection combined with chemotherapy(SUCRA=39.2%).Conclusion:Four kinds of health-strengthening and qi-nourishing Chinese herb injections combined with chemotherapy for breast cancer is safer and more effective than conventional western medicine.Since each intervention has different ranking results under different outcome indicators,clinical treatment can be based on different clinical purposes determine the choice of Chinese herb injections to maximize their clinical effect.