A Systematic Review Of The Efficacy And Safety Of Traditional Chinese Medicine Combined With Chemotherapy In The Treatment Of Breast Cancer

Purpose:1.To gain the evidence in clinical of TCM combined with chemotherapy in the treatment of breast cancer by evaluating the safety and efficacy.2.Through probing into problems about the clinical of TCM combined with chemotherapy in the treatment of breast cancer to futher standardize and guide clinical reaseach.Material and method:We searched CNKI(CNKI)(1994-2015.12), Wanfang database(WANFANG data)(1998-2015.12) and VIP database(VIP)(1989-2015.12), Chinese biomedical literature database(CBM)(1978-2015.12), Pub Med database(1966-2015.12), EMBASE(1974-2015.12)and the Cochrane Database(2015 year).According to the inclusion criteria and exclusion criteria,we obtained the desired clinical randomized controlled trials(RCT) and evaluated the final inclusion of the literature by Cochrane collaboration network bias risk assessment tool.The quantitative Meta analysis of the literature was realized through Rev Man5.3 statistical software and the publication bias of the literature was mainly achieved through the Stata12.0 statistical software.Results:1.102 articles were included in the final and the quality of the literature was analyzed--higher quality,medium quality and low quality were 2, 23 and 77,respectively.2. The effectiveness of treatment outcome:2.1In objective aspect, the combination of traditional Chinese medicine and chemotherapy is superior to chemotherapy alone(Z=10.50.P<0.00001). The included studies have sensitivity and good homogeneity(P = 0.93).Begg test of related literature showed that no publication bias was found( Pr=0.665>0.05) and subgroup analysis showed that: in addition to the influence on the results of the study in the Chinese medicine group was larger(RR=1.35, P < 0.000 01) vs(RR=1.29, P < 0.000 01).Other groups had little effect on the results. The overall result is robust.2.2In terms of physical fitness, Chinese medicine combined chemotherapy is better than chemotherapy alone group(Z=14.11, p<0.00001). All included studies have sensitivity and good homogeneity(P=0.95).Begg test of related literature showed that the literature have publication bias(Pr=0.000<0.05) and the robustness of the results still need to be further explored,subgroup analysis showed that subgroups of relative risk are close to the results of the study. The result shows that the results are robust.3.The safety of treatment outcomes:3.1.In reducing the incidence of severe bone marrow suppression, traditional Chinese medicine combined chemotherapy is superior to chemotherapy alone group(Z=10.74, p<0.00001). The included studies have sensitivity and good homogeneity(P = 1.00). Begg test of related literature showed that the literature have publication bias(Pr=0.006<0.05) and the robustness of the results still need to be further explored,subgroup analysis showed that in addition to the influence on the results of the study in the Chinese medicine group was larger(RR=0.50, P < 0.000 01) vs(RR=0.40, P < 0.000 01.Other groups had little effect on the result.The overall result is robust.3.2.In terms of reducing the incidence of severe gastrointestinal reactions,Chinese medicine combined chemotherapy is better than chemotherapy alone group(Z=10.14,p<0.00001).The included studies have sensitivity and good homogeneity(P = 0.97).Begg test of related literature showed that no publication bias was found( Pr=0.665>0.05),subgroup analysis showed that subgroups of relative risk are close to the results of the study. The result shows that the results are robust.4.Included in the 52 pieces of Chinese medicine prescription, Nourishing Qi, promoting blood circulation and removing blood stasis is the main drug and Qi detoxification, diuresis drug is secondary.5.Into 102 literatures of informed consent, a total of 27 study obtained ethics agreed that signed the informed consent.Conclusion:1. In terms of effectiveness and safety, traditional Chinese medicine combined chemotherapy group were superior to pure chemotherapy group.2. Different dosage forms of traditional Chinese medicine may have different effects on the effectiveness and safety of the treatment.3.Decoction of Chinese medicine contains more Nourishing Qi, promoting blood circulation and removing blood stasis drugs and Qi detoxification, diuresis drugs secondary..4.Traditional Chinese medicine combined with chemotherapy in the treatment of breast cancer clinical research in random, blind and other experimental design needs to be strengthened, ethical review need to be more rigorous, clinical data statistics need to be futher standardized.