Meta Analysis For Clinical Evaluation Of Traditional Chinese Medicine Combined With Radiofrequency Ablation In The Treatment Of Primary Liver Cancer

Objective:To evaluate and analyze the curative effect of Traditional Chinese medicine combined with radiofrequency ablation(RFA)in the treatment of primary liver cancer.Objective to provide evidence for clinical efficacy of traditional Chinese medicine combined with radiofrequency ablation in the treatment of primary liver cancer based on the statistical analysis of the tumor recurrence rate,short-term efficacy,quality of life,AFP,survival and other indicators.Methods:Retrieval studies of RCTs published from October 2001 to September 2016,which were involving Traditional Chinese Medicine(TCM)combined with radio frequency ablation(RFA)for primary liver cancer versus radiofrequency ablation(RFA)only,from database : Chinese Medical Current Contents(CBM),Wanfang database,CNKI China Chinese journal database(CNKI)and Chongqing VIP database(VIP),Pumed,Cohrane and Embase.Selected studies according to the inclusion and exclusion criteria,then evaluation the studies according to assessment scale of Jaded.Extracted effective data from the studies and analyze the tumor recurrence rate,short-term efficacy,quality of life(KPS score),AFP and survival with Rev Man5.3 software,then summarize the clinical curative effect and problems in clinical research of Traditional Chinese Medicine combined with radiofrequency ablation in the treatment of primary liver cancer.Results:There are 15 literatures were included in this study.A total of1080 patients with primary liver cancer were divided into two groups: the experimental group(n=552)and the control group(n = 528).Totally 104 articles were included in the study.All the articles included in the study were statistically analyzed and comparable to the general data.Meta analysis showed that the Traditional Chinese Medicine combined with radiofrequency ablation for the treatment of primary liver cancer with the end result of each index compared with radiofrequency ablation has the following advantages:(1)1 year recurrence rate was lower,the difference was statistically significant[RR=-0.28,95%CI(-0.46,-0.11),P=0.002<0.01];(2)The short-term curative effect of main symptoms of pain,fever,anorexia,abdominal distention,liver area(loss of appetite),jaundice is more effective,the difference was statistically significant and no statistical heterogeneity[OR=0.33,95%CI(0.19,0.48),P=0.00001<0.01],[RR=1.88,95%CI(1.08,3.27),P=0.03<0.05],[RR=1.58,95%CI(1.23,2.02),P=0.0003<0.01],[RR=1.84,95%CI(1.89,2.45),P=0.0001<0.01],[RR=1.77,95%CI(1.75,2.31),P=0.0001<0.01];(3)The effective rate of solid tumor and 1year survival rate were higher,but the difference was not statistically significant and no statistical heterogeneity also[RR=1.16,95%CI(1.0,1.34),P=0.06>0.05],[RR=1.1,95%CI(0.74,1.63),P=0.64>0.05].(4)The quality of life(KPS)score was higher and the rate of improvement was higher,the difference was statistically significant[MD=10.20,95%CI(7.72,12.68),P=0.000001<0.01]and[RR=1.61,95%CI(1.10,2.36),P=0.01<0.05],and no statistical heterogeneity;(5)AFP decreased significantly,and the difference was statistically significant[P=0.27>0.1,I2=22%<50%,MD=-277.89,95%CI(-317.11,-238.68),P=0.00001<0.01].Conclusion: Compared with radiofrequency ablation,Traditional Chinese Medicine combined with radiofrequency ablation in the treatment of primary liver cancer recurrence rate is lower,the main effect of the better,to reduce the effect of alpha fetoprotein is better,can significantly improve the quality of life of patients,However,large sample sizes and more standardized randomized controlled trials are needed.