Meta-analysis Of Traditional Chinese Medicine Decoction In The Treatment Of Cancer-related Fatigue And Mining Of Medication Rules

ObjectiveMeta analysis of randomized controlled trials of traditional Chinese medicine decoction in the treatment of cancer-related fatigue,and explore the prescription selection and medication rules of modern doctors in the treatment of cancer-related fatigue,so as to provide reference for clinical intervention of cancer-related fatigue.MethodsComprehensive retrieve CNKI,WanFang,VIP,CBM,PubMed,Embase,The Cochrane Library database,collect traditional Chinese medicine medicinal decoction in treatment of cancer-related fatigue research,retrieval time for libraries to December 31,2020.The literatures were screened according to the inclusion and exclusion criteria,the data were extracted and the quality of the included literatures was evaluated,the data were analyzed by Revman5.3 software.Retrieve CNKI,WanFang and VIP database about research on traditional Chinese medicine medicinal decoction in treatment of cancer-related fatigue,into a randomized controlled trial,expert experience and so on literature,the ancient and modern literature formula of input basis cloud platform to build database,using the method of data mining to analyze the prescription.Results1.A total of 33 studies included in this study,including 2596 participants,including 1320 observation group,control group in 1276,the data analysis results show that:Piper fatigue scale:the total scores,the results indicate:MD=-1.23,95%CI[-1.56,-0.91],P<0.00001,suggesting that the PFS score of the observation group was lower than that of the control group,difference have statistical significance;Each dimension score,the results showed:(behavior)MD=-1.26,95%CI[-1.57,-0.96],P<0.00001;(emotional)MD=-0.97,95%CI[-1.20,-0.73],P<0.00001;(feel)MD=-0.99,95%CI[-1.24,-0.74],P<0.00001;(cognitive)MD=-0.74,95%CI[-1.07,-0.41],P<0.0001,shows that the PFS each dimension score in observation group were lower than the control group,the difference was statistically significant.The Brief Fatigue Inventory:the results suggest:MD=-0.50,95%CI[-0.77,-0.23],P=0.0003,shows that the BFI score of the observation group was lower than that of the control group,the difference is statistically significant.Fatigue level:according to the results of PFS score rank,tip:RR=0.58,95%CI[0.50,0.69],P<0.00001,suggesting that the moderate and severe fatigue relief rate of the observation group was better than that of the control group,difference have statistical significance;Tip:according to the results of the BFI score rank,RR=0.52,95%CI[0.43,0.64],P<0.00001,suggesting that the moderate and severe fatigue relief rate of the observation group was better than that of the control group,the difference is statistically significant.Effective rate of treatment:according to TCM syndrome integral evaluation,the results suggest:RR=2.08,95%CI[1.59,2.71],P<0.00001,suggesting that the effective rate of the observation group was higher than that of the control group,the difference is statistically significant.KPS score:the results suggest:MD=8.95,95%CI[5.91,11.99],P<0.00001,suggesting that the observation group was better than the control group in improving KPS score,the difference is statistically significant.EORTC QLQ-C30 score:the total scores for health,the results hint:SMD=1.37,95%CI[1.19,1.56],P<0.00001,suggesting that the observation group was better than the control group in improving total health score,difference have statistical significance;Fatigue scores,the results suggest:MD=-20.85,95%CI[-36.28,-5.43],P=0.008,shows that the observation group was better than the control group in reducing fatigue score,the difference is statistically significant.Immune function:CD3+readings,results suggest:MD=7.99,95%CI[3.92,12.06],P=0.0001,to show that the observation group was better than the control group in improving the level of CD3+cells,the difference is statistically significant;CD4+ readings,results suggest:MD=7.22,95%CI[4.00,10.43],P<0.0001,suggesting that the observation group was better than the control group in improving the level of CD4+cells,the difference is statistically significant;CD8 readings,results suggest:MD=0.64,95%CI[-1.81,3.09],P=0.61,shows that in terms of level of CD8+cells,there was no statistically significant difference;CD4+/CD8+ ratio,the results suggest:MD=0.27,95%CI[0.07,0.47],P=0.008,to show that the observation group was better than the control group in improving the CD4+/CD8+ ratio,the difference is statistically significant;Level of NK cells,the results indicate:MD=3.80,95%CI[0.71,6.90].P=0.02,to show that the observation group was better than the control group in improving the level of NK cells,the difference is statistically significant2.In this study,83 literatures of traditional Chinese medicine decoction in the treatment of cancer-related fatigue were included,involving 106 prescriptions,the results are as follows(1)Use a higher frequency of the first five taste of drugs are Poria cocos,Atractylodes macrocephala Koids,Astragalus membranaceus,Chinese angelica and Dried tangerine peel.High frequency medicine is extracted for main Atractylodes macrocephala-Poria cocos,Atractylodes macrocephala-Astragalus membranaceus,Astragalus membranaceus-Poria cocos,Chinese angelica-Astragalus membranaceus,etc.Drug four gas is given priority to with flat,warm,mixed with sweet,bitter,bitter is given priority to,return the with spleen-invigorating the most,followed by the lungs.(2)The clustering analysis,Group 1:Poria cocos,Atractylodes macrocephala Koids,Astragalus membranaceus,Licorice,Heterophylly falsestarwort root,Hedyotis diffusa,Curcumae rhizome.Group 2 drugs are divided into 2 groups:?Dried tangerine peel,Chinese angelica,Codonopsis pilosula;?Fried licorice,Prepared rehmannia glutinosa,Radix paeoniae alba,Chinese wolfberry,Ophiopogon japonicus,Rehmannia glutinosa,Ginseng,Yam,Chicken's gizzard-membrane,Coicis Semen,Malt,Red tades,Ginger,etc(3)The core combinations:Poria cocos,Atractylodes macrocephala Koids,Astragalus membranaceus,Chinese angelica,Dried tangerine peel,Licorice,Codonopsis pilosula,Licorice,Codonopsis pilosula,Fried licorice,Heterophylly falsestarwort root,Yam,Chinese wolfberry,Prepared rehmannia glutinosa,Radix paeoniae alba,Ginseng,Hedyotis diffusa,Coicis SemenConclusions1.In terms of Meta-analysis,the observation group was better than the control group in the outcome indicators of PFS score.BFI score,fatigue degree,Effective rate of treatment,KPS score,EORTC QLQ-C30 score and immune function(CD3+?CD4+?CD4+/CD8+?NK cells),and the difference was statistically significant,indicating that the traditional Chinese medicine medicinal decoction in a certain extent can alleviate symptoms of patients with fatigue,improve clinical curative effect and quality of life,enhance the immune function.Due to the particularity of traditional Chinese medicine,the research methods such as poor quality reasons,led to the interpretation of the results need to be careful,need to do evidence to support the higher quality of literature.2.In terms of medication regularity,the treatment of cancer-related fatigue with modern Chinese medicine is mainly to invigorate the spleen,replenish qi,nourish blood and nourish yin,pay attention to the treated from the spleen,give consideration to the lung and kidney,remove pathogenic factors at the right time,and often combine with the products of promoting blood circulation,removing dampness and resolving phlegm,and detoxifying and dispersing knots,so as to achieve the purpose of both attacking and tonifying.Clinical use of sexual flavour and peaceful,and pay attention to the daily regulating,in order to improve the clinical curative effect.