| Purpose:To investigate the meta-analysis of the clinical efficacy of yiqi huoxue decoction in the treatment of primary liver cancer.Material and method:By computer retrieval way,retrieval time limited to 2000-2019,Chinese keywords for primary liver cancer,subheadings for "yiqi huoxue" or "yiqi blood" or "qi" or "fill gas blood" in the CNKI Chinese periodical database,a database of ten thousand,weipu database for retrieval,English subject for "hepatocellular carcinoma",Subheadings as "invigorating qi" or "promoting blood circulation" in the Pubmed database search,choose 263 paper,according to the literature and exclusion criteria,eventually won 14 article about basic legislation for yiqi huoxue formula RCT studies for the treatment of patients with primary liver cancer.The main outcome indicators included remission rate,stability rate,quality of life,post-treatment KPS score,6-month survival,12-month survival,post-treatment CD8+value,post-treatment CD4+ value,etc.Jadad Scale was used for evaluation,and Review Manager 5.2 software was used for meta-analysis.Results:1.Literature search results: this study finally obtained 14 RCT studies on primary liver cancer patients with the basic legislation of invigorating qi and activating blood circulation,with a total of 997 patients,487 in the control group and 510 in the observation group.The basic data of gender and age of the two included groups were comparable(P >,0.05).2.Basic characteristics of the literature: the Jadad scoring method was adopted for the evaluation,and the quality of the included literature was high.All the included literature blind methods were single blind.3.The legislation of yiqi huoxue formula analysis: yiqi medicines including astragalus,licorice,atractylodes,ginseng,acanthopanax,dangshen,yam,radix astragali drug use frequency is highest,a total of 12 articles mentioned in astragalus membranaceus,accounted for 85.71%,followed by 8 licorice are mentioned in the paper,accounted for 57.14%,6articles mentioned in atractylodes,accounted for 42.85%,5 articles were mentioned in ginseng,accounted for 50.00%,4 acanthopanax are mentioned in the paper,28.57%;Invigorate the circulation of drugs including rhizoma zedoariae,triangular,blister beetle,pangolin scales,peach kernel,trumpet creeper,rhizoma zedoariae drug use frequency is highest,a total of eight articles mentioned in rhizoma zedoariae,accounted for 57.14%,followed by five three edges are mentioned in the paper,accounted for 35.71%,4 cantharides are mentioned in the paper,accounted for 28.57%,4 pangolin scales are mentioned in the paper,accounted for 28.57%,3 peach kernel are mentioned in the paper,accounted for21.43%,3 trumpet creeper are mentioned in the paper,accounting for 21.43%.4.Heat medicine and medicine ziyin prescription analysis: heat medicine including spreading hedyotis herb,barbed skullcap herb,bear bile powder,Chinese gooseberry,fleas,dandelion,selfheal,pearl grass,radix scrophulariae,spreading hedyotis herb drug use frequency is highest,a total of 7 spreading hedyotis herb are mentioned in the paper,accounted for 50.00%,followed by 6 mentioned in these articles,accounted for 42.85%,4 articles mentioned in bear bile powder,accounted for 28.57%,3 are mentioned in the paper rattan pear root,accounting for 21.43%.Yin nourishing drugs include fructus liguttiana,native land,asparagus,and wolfberry fruit.Fructus liguttiana is the most frequently used drug,with reference to fructus liguttiana in 4 literatures,accounting for 28.57%.5.Clinical efficacy: response rate effect size RR and 95%ci were 1.34[1.17,1.53],Z=4.24(P< 0.0001).The rhombogram was on the right side of the graph.The effect size RR and 95%ci of the stability rate were 1.21[1.05,1.39],Z=2.61(P=0.009 < 0.01),and the rhombogram was located on the right side of the graph.Patients in the observation group had an advantage in the clinical stability rate.6.Quality of life: the quality of life effect size RR and 95%CI were 1.63[1.38,1.92],Z=5.74(P < 0.00001),and the rhombogram was located on the right side of the graph.Patients in the observation group had an advantage in quality of life.The KPS effect size RR and 95%CI after treatment were 8.82[6.37,11.26],Z=7.06(P < 0.00001),and the rhombogram waslocated on the right side of the graph.The observation group had an advantage in the KPS score after treatment.7.Survival: the 6-month survival effect size RR and 95%ci were 1.08[0.99,1.17],Z=1.82(P=0.07 > 0.01),and the rhomboid graph was in the middle of the graph.There was no difference between the observation group and the control group in the 6-month survival.The12-month survival effect sizes RR and 95%ci were 1.33[1.11,1.61],Z=3.01(P=0.003 < 0.01),and the rhombogram was on the right side of the graph.Patients in the observation group had an advantage in 12-month survival.8.Immune function: the value of CD8+ effect RR and 95%CI after treatment were3.53[-3.49,10.56],Z=0.99(P=0.32 > 0.01),and the rhomboid diagram was in the middle of the figure.There was no difference in the value of CD8+ between the observation group and the control group after treatment.After treatment,the CD4+ numerical effect size RR and95%CI were 6.02[-1.51,13.55],Z=1.57(P=0.12 > 0.01),and the rhomboid diagram was in the middle of the figure.There was no difference in the CD4+ value between the observation group and the control group after treatment.Conclusion:1.Through this meta-analysis,it was found that astragalus,licorice,rhizoma atractylodes,radix atractylodes and ginseng were often used for the treatment of primary liver cancer,and blood-activating drugs such as zedoary rhizome,tricarris,cantharides and pangolin were often used.In the treatment of primary liver cancer with qi-invigorating and blood-activating drugs,according to the syndrome differentiation of the disease,the different stages of the disease,the patient's own situation dialectical treatment plus the use of heat clearing phlegm,invigorating the spleen and removing dampness,blood and kidney nourishing Yin and other drugs for individual treatment.2.This study found that,compared with conventional treatment,the method of invigorating qi and activating blood circulation can improve the clinical efficacy,quality of life and survival time of patients with primary liver cancer.Therefore,the method of invigorating qiand activating blood circulation is worthy of clinical application and promotion in the treatment of primary liver cancer.The specific KPS score value is not mentioned in most literatures.It is suggested that future studies should focus on the evaluation of quality of life and increase the specific value of KPS score after treatment to improve the quality of literatures.3.This study found that,compared with conventional treatment,the method of invigorating qi and activating blood circulation had no significant effect on immune function,which may be due to the fact that TCM treatment based on syndrome differentiation emphasizes the overall concept and the treatment starts from the whole to improve local problems,which is obviously different from western medicine to improve a specific index.It may also be that there is little literature on immune cells included in this study or that there is a correlation between immunosuppression and immune escape in advanced primary liver cancer. |
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