Meta-Analysis Of Clinical Efficacy And Medication Rules Of Oral Chinese Medicine In The Treatment Of Colorectal Cancer

Objectives This article systematically comment on the clinical efficacy of TCM in the treatment of CRC by evidence-based medicine method,and to analyze the medication rules and characteristics of such medicines by data mining,for the purposes of providing a certian reference for TCM clinical treatment of colorectal cancer.Methods 1.Meta-analysis:Clinical randomized controlled studies on the treatment of colorectal cancer based on qi by TCM in the last five years were retrieved in CNKI,WANGFANG DATE,VIP,CBM,and Pub Med databases by using the combination of mesh and free words.The target literature was strictly screened out according to the inclusion and exclusion criteria.The corresponding outcome index data were extracted,and quality evaluation and data processing were performed by using Review Manager 5.4 and STATA17.0 software.2.Medication Rules:The clinical studies and clinical observations on the treatment of colorectal disease by TCM in the last five years were retrieved in CNKI,WANGFANG DATE,VIP,CBM,and Pub Med databases by using a combination of mesh and free words.According to the inclusion and exclusion criteria to screen out the studies that meet the criteria,extract the TCM prescriptions.Then standardizing the names of the herbal medicines and creating a database.Frequency analysis,association rule analysis,and cluster analysis were performed on the standardized prescriptions with the help of Microsoft Excel 2019,SPSS Statistics 26.0,and SPSS Modeler 18.0 software,and finally,analyzed and concluded medication rules.Results 1.56 articles met the criteria and were included,including 4449 patients.A total of 54studies reported objective efficacy rate,3 studies reported 1-year survival,16 studies reported TCM syndrome efficacy,18 studies reported CEA,14 studies reported CA19-9,21 studies reported CD4~+T cell,18 studies reported CD8~+T cell,and 13 studies reported KPS functional status scores:Objective efficacy rate:RR=1.41,95%CI=[1.32,1.49],P<0.05 1-year survival rate:RR=1.15,95%CI=[1.02,1.29],P<0.05 TCM syndromeefficacy:RR=1.49,95%CI=[1.36,1.64],P<0.05 CEA:SMD=-1.68,95%CI=[-2.25,-1.12],P<0.05 CA19-9:SMD=-1.53,95%CI=[-2.12,-0.94],P<0.05 CD4~+T cell:SMD=1.54,95%CI=[1.16,1.93],P<0.05 CD8~+T cell:SMD=-1.01,95%CI=[-1.36,-0.66],P<0.05 KPS:MD=6.24,95%CI=[5.38,7.10],P<0.05The results showed that all outcome indicators in the treatment group were better than those in the control group.96 qualified articles were included in the analysis of medication rules,with a total of 104prescriptions involving 211 relevant Chinese materia medica,and the prescription with the most kinds of medicine contained 30 kinds and the least contained 5 kinds.(2)The most frequently used medicine are Baizhu,Huangqi,Fuling,Chenpi,Dangshen,Yiyiren,Danggui,Banxia,Baihuasheshecao.The most frequently of efficacy is qi-supplementing,diuresis and diffusing dampness,and carminative,and The maximum dose is Huangqi its use of 60g.The nature of medicine are mainly cold,warm,and flat,the flavours of medicine are mainly bitter,sweet,and pungent.The channel entry are mainly liver channel,lung channel,spleen channel,and stomach channel.(3)The strongly associated core medicine are Baizhu-Banxia,Baihuashesehcao-Huangqi,Chenp-Huangqi-Baizhu,Fuling-Huangqi-Baizhu,etc.(4)The results of medicine cluster analysis:(1)Huangqi,Baihuasheshecao,Ezhu;(2)Taizishen,Nvzhenzi,Yiyiren,Shanyao,Banzhilian;(3)Dangshen,Muxiang;(4)Jineijin,Maiya,Baizhu,Fuling,Chenpi,Banxia,Zhiqiao;(5)Danggui,Chaihu,Baishao.Conclusion 1.There were eight outcome indicators had statistically significant difference in objective efficacy rate,1-year survival rate,TCM syndrome efficacy and the quality of life,reducing serum tumor marker levels and improving immune function.2.The medicine used more frequently in clinical TCM based on qi for colorectal cancer are Bai Zhu,Huang Qi,Fu Ling,etc.The most frequently of efficacy is qi-supplementing,diuresis and diffusing dampness,and carminative.The treatment emphasizes invigorating spleen and replenishing qi,and regulating qi-flowing to remove stagnation.The formula has the characteristics of reinforcement and elimination in combination,and regulating the liver,lung,and spleen qi simultaneously.