| Objective:The method of meta-analysis was used to evaluate the clinical efficacy and safety of traditional Chinese medicine and Western medicine in the treatment of radiation proctitis(RP)in patients with cervical cancer,and to provide evidence-based medicine basis for the selection of clinical treatment plans.Methods: Databases such as CNKI,Wanfang,China Biomedical Literature Database(CBM/Sino Med),VIP Chinese Periodical Database(VIP),Pub Med Database,Cochrane Database,and Embase Database were searched by computer.All clinical randomized controlled trials(RCTs)using traditional Chinese and Western medicine in the treatment of radiation proctitis were searched,and the retrieval time was from the establishment of the database to January 2022.In addition,the missing detection of possible literatures was minimized through the search of references.All included literatures were screened according to the inclusion criteria and exclusion criteria of this study,and the Cochrane risk bias assessment tool in the Review Manager 5.3software was selected to strictly evaluate the quality of the included documents.Then,incorporate the documents that meet the standards,and finally extract the relevant required data from all the included documents.Rev Man5.3 software was selected for statistical analysis.Result: According to the inclusion and exclusion criteria,13 literatures were finally included,all of which were randomized controlled studies.A total of 963 trial personnel were included,487 in the experimental group while 476 in the control group.The main outcome indicators are: the curative effect、the score of rectal mucosa、the KPS score、the TCM symptom score and the inflammatory cytokines.According to the statistical results of Revman5.3,it is shown that in the clinical efficacy of treating RP patients[1],13 literatures all described the total effective rate of TCM treatment and intervention(OR = 4.76,95% CI = 3.19~7.09,Z = 7.65,P < 0.00001),it shows that integrated traditional Chinese and Western medicine can achieve better therapeutic effect in the treatment of radiation proctitis in patients with cervical cancer.For rectal mucosa score of patients with radiation proctitis[2],two research data were extracted and compared before and after treatment(MD=-2.33,95% CI =-2.54~-2.12,Z=21.89,P<0.00001),it shows that the study group treated by TCM intervention can significantly reduce rectal mucosa score and promote the recovery of intestinal mucosa.For KPS score(Karlsky score)of patients with radiation proctitis[3],two research data were extracted and the functional status scores of patients before and after treatment were compared(MD=5.81,95% CI = 3.59~8.02,Z=5.15,P<0.00001),it shows that traditional Chinese medicine combined with Western medicine can significantly improve the physical state and quality of life of patients with radiation proctitis.On the score of TCM symptoms of patients with radiation proctitis[4],three research data were extracted to compare the improvement of abdominal pain(MD =-0.67,95% CI =-0.76~-0.57,Z=13.76,P<0.00001)and the improvement of abdominal pain after acute illness(MD=-0.47,95%CI=-0.55~-0.40,Z=12.56,P<0.00001),two study data were extracted to compare the improvement of hematochezia(MD=-0.63,95% CI =-0.74~-0.51,Z=10.88,P<0.00001),and two study data were extracted to compare the improvement of abdominal distension(MD=-0.50,95%CI=-0.59~-0.42,Z=11.40,P<0.00001).All of the above indicate that the intervention of traditional Chinese medicine has obvious advantages in relieving symptoms such as abdominal pain,abdominal distension,hematochezia and abdominal distress.Interleukin-1(IL-1),Interleukin-6(IL-6)and Tumor Necrosis Factor-α(TNF-α)are closely related inflammatory cytokines in radiation proctitis[5].Among the 13 RCT literatures included,three research data were extracted to compare the changes of IL-1 before and after treatment(MD=-8.79,95% CI =-9.73~-7.85,Z=18.37,P<0.00001),and changes of TNF-α before and after treatment:(MD=-18.19,95% CI =-19.47~-16.92,Z=28,P<0.00001).Four research data were extracted to compare the improvement of IL-6 before and after treatment(MD=-8.28,95% CI =-9.30~-7.26,Z=15.93,P<0.00001).The above results show that the research group after the intervention of traditional Chinese medicine has more obvious advantages in reducing the inflammatory response of the body.Conclusions:In the treatment of radiation proctitis in patients with cervical cancer,the treatment of integrated traditional Chinese and Western medicine has obvious advantages in the improvement of clinical efficacy,rectal mucosal score,KPS score,TCM symptom score and inflammatory cytokines than the treatment of simple western medicine,and which can significantly slow down the adverse reactions,reduce inflammatory reactions and improve the quality of life.It is suggested to be popularized in clinic. |
PDF Full Text Request