Meta-analysis Of Traditional Chinese Medicine Combined With Chemotherapy In The Treatment Of Malignant Lymphoma

[Objective]To evaluate the clinical benefits of the Traditional Chinese Medicine (TCM) with chemotherapy for Lymphoma.[Methods]Studies of RCTs published from 1970 to January,2016, which were involving TCM combined with chemotherapy for Lymphoma versus chemotherapy alone, from databases: Chinese Medical Current Contents, Chinese National Knowledge Infrastructure, Chinese Sci & Tech Journals, PubMed and the Cochrane Collaboration Controlled Trials Center database. All studies were selected witch a strict criteria.Relevant information and Valid data were extracted:Overall response rate, Untoward effect:leucopenia, Anemia, thrombocytopenia and intestinal disorders. Data were analyzed by using Cochrane software Revman 5.1.[Results]12 trials involving 789 patients met the inclusion criteria.12 trails were analyzed in Meta-analysis of Overall response of Traditional Chinese Medicine combined with chemotherapy for Lymphoma when comparing to chemotherapy.9 trails were analyzed in Meta-analysis of preventing untoward effect leucopenia of Traditional Chinese Medicine combined with chemotherapy for Lymphoma when comparing to chemotherapy.5 trails were analyzed in Meta-analysis of preventing untoward effect Anemia of Traditional Chinese Medicine combined with chemotherapy for Lymphoma when comparing to chemotherapy.7 trails were analyzed in Meta-analysis of preventing untoward effect thrombocytopenia of Traditional Chinese Medicine combined with chemotherapy for Lymphoma when comparing to chemotherapy.6 trails were analyzed in Meta-analysis of preventing untoward effect intestinal disorders of Traditional Chinese Medicine Combined with chemotherapy for Lymphoma when comparing to Chemotherapy[Meta-analysis]1 There was a significant improvement in Overall response RR=1.16,[95%CI(1.05,1.27)]of Traditional Chinese Medicine combined with chemotherapy for Lymphoma when comparing to chemotherapy (Z=3.05(P=0.002).All the studies had homogeneity X2=15.24,df=11,p=0.17 I2=28%.In the subgroup analysis,the'Chinese Patent medicine'subgroup and the'decoction' subgroup had no differences of clinical benefits compared with Chemotherapy alone.2 There was an evidence of a improvement in preventing untoward effect leucopenia RR=0.57,[95%CI(0.48,0.69)] of Traditional Chinese Medicine combined with chemotherapy for Lymphoma when comparing to chemotherapy Z=5.77(P<0.00001). All the studies had homogeneity X2=4.19,df=7,P=0.76,I2=0%. In the subgroup analysis, the "Chinese Patent medicine" group had a greater difference than other groups RR=0.66..3 There was an evidence of a improvement in preventing untoward effect Anemia RR=0.67,[95%CI(0.52,0.86)] of Traditional Chinese Medicine combined with chemotherapy for Lymphoma when comparing to chemotherapy Z=3.12(P=0.002).All the studies had homogeneity,X2=3.27,df=4,P=0.51,12=0%.4 There was an evidence of a improvement in preventing untoward effect thrombocytopenia RR=0.60,95%CI[0.37,0.96] of Traditional Chinese Medicine combined with chemotherapy for Lymphoma when comparing to chemotherapy Z=2.14(P=0.03).All the studies had heterogeneityX2=18.10,df=6,P=0.006,I2=67%,through sensitivity analysis, found out 2 studies were the cause of the heterogeneity.5 There was an evidence of a improvement in preventing untoward effect intestinal disorders RR=0.64,95%CI[0.51,0.80] of Traditional Chinese Medicine Combined with chemotherapy for Lymphoma when comparing to Chemotherapy Z=3.85(P=0.0001).All the studies had homogeneity,X2=3.50,df=5,P=0.62,I2=0%.There were 12 studies selected in this research, only 1 trail mentioned the method of random assignment,the other 11 of them just mentioned "random assignment", did not provided the detail of it. All the studies did not mention Allocation concealment, Blinding of participants and personal and Blinding of outcome assessment, for those reasons, there existed unclear risk of selection bias and performance bias and detection bias.[Conclusions]There was a significant improvement in Overall response, of Traditional Chinese Medicine combined with chemotherapy for Lymphoma when comparing to chemotherapy. There also were evidences of improvements in preventing untoward effects:leucopenia, Anemia, thrombocytopenia and intestinal disorders.