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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front. Med.    2017, Vol. 11 Issue (2) : 191-202     DOI: 10.1007/s11684-017-0512-0
REVIEW |
Effect of traditional Chinese medicine combined with Western therapy on primary hepatic carcinoma: a systematic review with meta-analysis
Li Ma1, Bin Wang1, Yuanxiong Long1, Hanmin Li2()
1. Hubei University of Chinese Medicine, Wuhan 430065, China
2. Hepatopathy Institute, Affiliated Hospital of Hubei University of Chinese Medicine (Chinese Medicine Hospital in Hubei Province), Wuhan 430061, China
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Abstract  

Primary hepatic carcinoma (PHC) is a common malignant tumor in China. Cancer is comprehensively treated with various therapeutic regimes, including traditional Chinese medicine (TCM). TCM has been widely used to improve the quality of life, delay the time of cancer progression, and prolong the median survival time. This systematic review with meta-analysis aimed to assess the effect of TCM combined with Western therapy on primary hepatic carcinoma. A comprehensive literature search was conducted in six databases, including CNKI, VIP, Wan-Fang Database, CBM, PubMed, and Cochrane library. A total of 44 randomized controlled trials (RCTs) involving 3429 participants suffering from PHC were selected. Meta-analysis results indicated that the overall effect of TCM and Western integrative treatment on PHC was higher than that of Western intervention alone, which can postpone tumor recurrence and metastasis and prolong the overall survival time of patients with PHC. Although the obtained evidence remained weak because of the poor methodological quality of the included studies, this review provided relevant data supporting the efficacy and safety of TCM combined with Western therapies. In future research, individual RCT studies should incorporate accepted standards for trial design and reporting, proper outcome indicators according to international standards, blinding in allocation concealment, and valid follow-up periods.

Keywords traditional Chinese medicine      primary hepatic carcinoma      meta-analysis     
Corresponding Authors: Hanmin Li   
Just Accepted Date: 21 February 2017   Online First Date: 27 March 2017    Issue Date: 01 June 2017
URL:  
http://academic.hep.com.cn/fmd/EN/10.1007/s11684-017-0512-0     OR     http://academic.hep.com.cn/fmd/EN/Y2017/V11/I2/191
Fig.1  Flow diagram of study inclusion and exclusion.
StudiesTreatment measuresSample sizeOutcomesAverage ageClinical stagesTreatment
duration
Experimental groupControl group(E/C)(E/C)
Wang et al., 2009 []Chemotherapy plus CHM formulaChemotherapy40/37C, D51.67/52.4Mid-late4-6 weeks
Yan et al., 2007 []Oral medication plus CHM formulaOral medication87/42B52.3/51.5Mid-late1 month
Cui, 2013 []Chemotherapy plus CHM formulaChemotherapy39/39A, D51.2/53.1Mid8 weeks
Hanet al., 2009 []Oral medication plus CHM formulaOral medication24/24A, B-Mid-late3-4 months
Tian et al., 2009 []Oral medication plus Aidi injection and CHM formulaOral medication30/30C, D60.4/61.2Late3 months
Lin, 2012 []Chemotherapy plus CHM formulaChemotherapy80/80A, C-Late2 months
Liu et al., 2005 []Chemotherapy plus CHM formulaChemotherapy33/33A, B, D58.15/57.61Mid-late1 month
Chen et al., 2009 []Chemotherapy plus Xiaoaiping injectionChemotherapy56/43A, D-Mid-late2-3 weeks
Zhou, 2010 []Oral medication plus Cinobufotalin injectionOral medication29/29A, C-Mid-late20 days
Bai et al., 2012 []Radiotherapy plus Kangai injectionRadiotherapy25/25A, D-Mid-late6 months
Lin et al., 2009 []Radiotherapy plus Kangai injectionRadiotherapy42/40A, D50.6/49.3Mid-late4 weeks
Deng et al., 2004 []Radiotherapy plus CHM formulaRadiotherapy56/39C-Mid-late1 month
Pang et al., 2012 []Radiotherapy plus CHM formulaRadiotherapy48/52A, C, D-Mid-late2?3 months
Xiang, 2009 []Surgery plus CHM formulaSurgery40/40A59.38/50.56Mid-late3 month
Chen et al., 2005 []Surgery plus CHM formulaSurgery30/30C48/49Mid-late1 month
Chen et al., 2012 []Surgery plus Cinobufotalin injectionSurgery127/82C51.35/47.98Early-mid3-6 months
Chen et al., 2005 []Surgery plus CHM formulaSurgery42/30C-Mid-late2 years
Lin et al., 2005 []TACE plus CHM formulaTACE25/25C-Mid-late2 months
Zheng et al., 2010 []TACE plus CHM formulaTACE30/31A46.2/45.2Mid-late1 month
Gu, 2011 []TACE plus CHM formulaTACE32/32A, C46.8/47.4Mid-late2 months
Lin, 2008 []TACE plus CHM formulaTACE58/58A, B56.5/57.6Mid-late2 months
Zhang et al., 2012 []TACE plus CHM formulaTACE43/40A, C, D46.9/45.8Mid-late2 courses
Zeng et al., 2011 []TACE plus CHM formulaTACE37/30A, B, D53.6/54.5Mid-late2 months
Di et al., 2010 []TACE plus CHM formulaTACE32/30A, B, C, D54.6/56.1Mid-late4 months
Lu et al., 2011 []TACE plus CHM formulaTACE34/32B55/56Mid-late3 months
Chi et al., 2010 []TACE plus CHM formulaTACE60/60A, B, C-Mid-late2 months
Li et al., 2011 []TACE plus CHM formulaTACE38/36A, B, C54.1/52.7Mid-late2 months
Zhang et al., 2008 []TACE plus CHM formulaTACE31/30A, C51.3/49.1Mid-late2 months
Yang et al., 2011 []TACE plus Aidi injectionTACE30/30B, C49.8/49Mid-late1 month
Yang, 2008 []TACE plus Aidi injectionTACE20/20A, B-Late2-3months
Zhang et al., 2009 []TACE plus CHM formulaTACE52/51C48/46Mid-late4 weeks
Ling, 2010 []TACE plus CHM formulaTACE64/64A, B-Mid-late2-3 months
Rong et al., 2013 []TACE plus CHM formulaTACE30/30A-Mid-late1-2 months
Jiang et al., 2012 []TACE plus CHM formulaTACE43/40A, C46.9/45.8Mid-late2 months
Tang et al., 2014 []Oral medication plus CHM formulaOral medication31/30A, C49.21/48.64Mid-late2 months
Zhang, 2014 []Radiotherapy plus CHM formulaRadiotherapy32/31A, C, D55.3/54.8Mid-late3 months
Tan, 2014 []TACE plus CHM formulaTACE34/34A52.9/51.29Mid-late3 months
Shang et al., 2014 []TACE plus CHM formulaTACE30/29A-Mid-late1 month
Qiao et al., 2014 []TACE plus CHM formulaTACE40/38A50.32/50.28Mid-late6 weeks
Li, 2014 []TACE plus CHM formulaTACE39/39B56.3/54.8Mid-late-
Qin, 2014 []TACE plus CHM formulaTACE40/40A63.5/61.5Mid-late-
Tang, 2014 []Oral medication plus CHM formulaOral medication30/30A59.1/61.3Mid-late4 weeks
Wang, 2014 []Oral medication plus CHM formulaOral medication30/30B46.9/47.1Mid-late3 months
Wang et al., 2014 []TACE plus CHM formulaTACE38/22B53.5/52.1Mid-late4?6 weeks
Tab.1  Characteristics of included studies
Fig.2  Forest plot with a combined result of meta-analysis for odds ratio (OR) of short-term clinical efficacy.
Fig.3  Forest plot with a combined result of meta-analysis for odds ratio (OR) of the quality of life.
Fig.4  Forest plot with a combined result of meta-analysis for odds ratio (OR) of adverse effect.
Fig.5  Funnel plot of short-term clinical efficacy.
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