| Background:Breast cancer is the most common malignancy in women all over the world.In 2015,there were about 272,000 new cases of breast cancer and more than 70,000 related deaths in China.About 3%-10%women are newly diagnosed with distant metastasis breast cancer each year.On the other hand,in early stage patients,30%-40%patients could develop into advanced breast cancer,and the 5-year survival rate is only 20%.At present,three main treatment methods for advanced breast cancer are chemotherapy,endocrine therapy and targeted therapy.A large number of clinical studies have shown that traditional Chinese medicine has superiorities in restraining tumor growth and reducing toxicity and enhancing efficacy of adjuvant chemotherapy.Breast cancer patients take deficiency of vital qi as the basis,combined with the external factors such as emotional failure,diet disorders,so that chong ren disorders,qi stagnation and blood stasis endogenesis,blood stasis and toxin coagulation in the breasts,namely breast cancer.Different anti-tumor TCM injections have different characteristics and curative effects in both fuzheng and quxie.Traditional Chinese medicine injection has the characteristics of high efficacy,convenient application,so that it can be widely used in clinic.However,the incidence of adverse reactions/events is high,and its medication safety is of great concern.In this context,multiple evidence-based researches and safety re-evaluation to guide rational drug use and reduce clinical risks are the primary tasks for the development of TCM injections both in the present and future.Objective:In this study,Meta-analysis was conducted on domestic and foreign literatures of randomized controlled studies on the treatment of advanced breast cancer with chemotherapy on the basis of five kinds of traditional Chinese medicine injections included in the national directory of medical insurance,to evaluate the efficacy and safety of five kinds of traditional Chinese medicine injections in the adjuvant treatment of advanced breast cancer.Methods:Searching literatures from CNKI,Wangfang Data,VIP,SinoMed,PubMed,Embase and The Cochrane Library database,until March 2019.Assess the risk of bias,and use RevMan5.3 software combined homogeneous research for Meta-analysis.Results:After searching and screening,a total of 52 studies including a total of 3792 patients were included.(1)Short-term effective rate:5 kinds of TCM injections combined with chemotherapy have positive effects.(2)Rate improvement of quality of life:shenmai injection,fufang kushen injection and aidi injection combined with chemotherapy have positive effects.(3)Leukopenia incidence:4 kinds of TCM injections combined with chemotherapy can reduce the overall incidence of leukopenia,and both fufang kushen and aidi injection can reduce the risk of grade ?-? leukopenia.(4)Incidence of nausea and vomiting adverse reactions:shenmai injection and fufang kushen inj ection combined chemotherapy have a role for decreasing the occurrence of nausea and vomiting,and fufang kushen injection can reduce the level ?-? nausea and vomiting at the same time,however,the existing evidence is not enough to prove that aidi injection and cinobufagin effect in this respect.(5)Immune function:shenmai injection,fufang kushen and aidi injection had positive effects on T-cell subgroup CD positive cells.At present,the evidence is not enough to prove the effect of fufang kushen injection on serum immunoglobulin contentConclusion:Meta-analysis results showed that 5 kinds of injection could improve the short-term effective rate,improve the quality of life of patients,and reduce the incidence of leukopenia and nausea.Among them,the evidence of the effect of aidi injection and cinobufagin on the incidence of nausea and vomiting is not enough to draw related conclusions in this study,and the effect and safety of each injection combined with chemotherapy on the immune function of patients also need to be further studied and discussed. |
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