Efficacy of Traditional Chinese Medicine Combined with Chemotherapy in the Treatment of Gastric Cancer: A Meta-analysis

Abstract

Objective. Meta-analysis was conducted to explore the effects of CM combined with chemotherapy on the effective rate and survival rate of gastric cancer patients. Methods. Literature retrieval was performed in PubMed, MEDLINE, Embase, CENTRAL, and CNKI databases. The subject of the literature was to compare the efficacy of CM combined with chemotherapy and chemotherapy alone in patients with gastric cancer. According to the Cochrane manual, the risk of bias was assessed for inclusion in randomized controlled trials. The chi-square test was used for the heterogeneity test. Subgroup analysis and sensitivity analysis were used to explore the causes of heterogeneity. Funnel chart and Egger’s test were used to assess publication bias. Results. This study included 761 patients with gastric cancer from 10 literatures. The effective rate of chemotherapy in the CM combined group was higher than that in the chemotherapy alone group (odds ratio $\left(\text{OR}\right)=1.96$ , 95% confidence interval (CI) (1.39, 2.78), $Z=3.81$ , $P=0.0001$ ), and there was no heterogeneity among studies ( $\text{ch}{\text{i}}^2=5.68$ , $P=0.68$ , $I^2=0$ %). There was no significant publication bias among all studies ( $P>0.05$ ). The one-year survival rate in the CM combined group was higher than that in the chemotherapy alone group ( $\text{OR}=3.25$ , 95% CI (1.90, 5.54), $Z=4.32$ , $P<0.0001$ ). There was no heterogeneity among studies ( $\text{ch}{\text{i}}^2=1.04$ , $P=0.79$ , $I^2=0$ %) and no significant publication bias among studies ( $P>0.05$ ). The 3-year survival rate of gastric cancer patients in the traditional Chinese medicine combination group was higher than that in the chemotherapy alone group ( $\text{OR}=1.71$ , 95% CI (1.06, 2.78), $Z=2.18$ , $P=0.03$ ). There was no heterogeneity among studies ( $\text{ch}{\text{i}}^2=2.18$ , $P=0.54$ , $I^2=0$ %), and there was no significant publication bias ( $P>0.05$ ). The incidence of nausea and vomiting after chemotherapy in gastric cancer patients in the Chinese medicine combination group was lower than that in the chemotherapy alone group ( $\text{OR}=0.47$ , 95% CI (0.34, 0.64), $Z=4.80$ , $P<0.00001$ ). There was no heterogeneity among studies ( $\text{ch}{\text{i}}^2=8.57$ , $P=0.48$ , $I^2=0$ %), and there was no significant publication bias ( $P>0.05$ ). Conclusion. CM combined with chemotherapy can improve the effective rate and survival rate of gastric cancer and reduce the incidence of nausea and vomiting after chemotherapy. We recommend a large sample size, multicenter combined randomized controlled trial for validation.