World Journal of Traditional Chinese Medicine (Jan 2019)
Therapeutic effect of jianpi decoction combined with chemotherapy on postoperative treatment of colorectal cancer: A systematic review and meta-analysis
Abstract
Objective: The purpose of this systematic review is to assess the therapeutic effect of Jianpi decoctions in Chinese herbal medicines (CHM) combined with chemotherapy on the postoperative treatment of colorectal cancer. Methods: Literatures were obtained from Wanfang database, CNKI, PubMed, Cqvip, MEDLINE, Cochrane, CBM, and Springer LINK as well as other conference papers and theses. The search included all documents in English or Chinese published before September 2018. We selected randomized controlled trials based on specific criteria and the most important criteria were that Jianpi decoction should be applied in combination with chemotherapy on the postoperative treatment of colorectal cancer. Results: Publications in eight electronic databases were extensively searched and 20 trials were included for analysis eventually. A total of 1652 patients in total were enrolled in these studies. Among them, 879 patients received CHM and Western medicine combination therapy and another 773 participants only got Western medicine therapy. Compared with those patients receiving Western medicine alone, the survival rate of 1-year (odds ratio [OR] = 2.35, 95% confidence limit [Cl] = 1.30–4.28,P < 0.05), 3-year (OR = 2.02, 95% Cl = 1.49–2.73,P < 0.001), and 5-year survival rate (OR = 2.32, 95% Cl = 1.56–3.45,P < 0.001) of patients in the group of Jianpi decoctions in CHM and chemotherapy combination has significantly increased. Moreover, results also showed positive effects on immunoregulation such as CD3+ (OR = 0.68, 95% confidence interval [CI] = 0.52–0.85,P < 0.0001), CD4+/CD8+ (OR = 0.77, 95% CI = 0.29–1.26,P < 0.05). Side effects caused by chemotherapy such as nausea (OR = 0.35, 95% CI = 0.25–0.50,P < 0.0001) and vomiting (OR = 0.32, 95% CI = 0.22–0.46,P < 0.0001), diarrhea (OR = 0.42, 95% CI = 0.30–0.60,P < 0.0001), as well as metastasis and recurrence (OR = 0.38, 95% CI = 0.24–0.61,P < 0.001) were remarkably reduced. The quality of life (OR = 4.40, 95% Cl = 2.86–6.77,P < 0.0001) has been improved. Moreover, there was no statistically significant bias in the overall studies. Conclusion: This systematic review suggests that Jianpi decoction in CHM can reduce the chemotherapy toxicity, enhance the patient's immunity, prolong their survival rate, improve their quality of life as well as prevent metastasis, and recurrence for patients in postoperative treatment of colorectal cancer.
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