Adjuvant therapy

辅助治疗
  • 文章类型: Journal Article
    在常规肿瘤化疗领域,抗癌化疗(AC)已成为治疗癌症的有效策略。AC是实体和非实体癌症治疗的主要策略。其机制作用针对肿瘤细胞中DNA转录的阻断和细胞周期机制的失调,导致死亡途径的激活。然而,伴随的AC对健康组织的毒性副作用提出了巨大的挑战。AC毒性副作用的罪魁祸首是未知的,虽然氧化应激,线粒体损伤,炎症级联,自噬失调,凋亡,并且涉及某些异常信号。蜂蜜是一种天然蜂产品,具有显着的健康益处和药理特性。有趣的是,文献报道,蜂蜜可能为脆弱的组织/器官提供保护机制,以抵抗AC毒性的副作用。因此,这篇综述探讨了蜂蜜作为AC毒性副作用缓解剂的预期作用;它阐明了AC毒性的机制和蜂蜜缓解的分子机制。该评论试图解开蜂蜜协调其缓解作用的特定分子级联,其总体目标是完善其作为佐剂天然产品的应用。蜂蜜补充剂通过抑制氧化应激来预防AC毒性,NF-κB介导的炎症,和半胱天冬酶依赖性凋亡级联反应。虽然有必要增加机械研究,蜂蜜是一种天然产品,可以减轻由AC引起的各种毒性。
    Within the domain of conventional oncochemotherapeutics, anticancer chemotherapy (AC) has emerged as a potent strategy for the treatment of cancers. AC is the mainstay strategy for solid and non-solid cancer treatment. Its mechanistic action targets the blockage of DNA transcription and the dysregulation of cell cycle machinery in cancer cells, leading to the activation of death pathways. However, the attendant side effect of toxicity inflicted by AC on healthy tissues presents a formidable challenge. The crucial culprit in the AC side effect of toxicity is unknown, although oxidative stress, mitochondrial impairment, inflammatory cascades, autophagy dysregulation, apoptosis, and certain aberrant signaling have been implicated. Honey is a natural bee product with significant health benefits and pharmacological properties. Interestingly, the literature reports that honey may proffer a protection mechanism for delicate tissue/organs against the side effect of toxicity from AC. Thus, this review delves into the prospective role of honey as an alleviator of the AC side effect of toxicity; it provides an elucidation of the mechanisms of AC toxicity and honey\'s molecular mechanisms of mitigation. The review endeavors to unravel the specific molecular cascades by which honey orchestrates its mitigating effects, with the overarching objective of refining its application as an adjuvant natural product. Honey supplementation prevents AC toxicity via the inhibition of oxidative stress, NF-κB-mediated inflammation, and caspase-dependent apoptosis cascades. Although there is a need for increased mechanistic studies, honey is a natural product that could mitigate the various toxicities induced by AC.
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  • 文章类型: Journal Article
    非小细胞肺癌(NSCLC)的围手术期治疗应控制局部和微观的全身性疾病,因为除IA期患者外,仅接受手术切除的NSCLC患者的生存率很低.改善手术结果的一种方式是在外科手术之前或之后施用化学疗法。在过去的二十年里,许多临床研究集中在开发基于顺铂的最佳辅助或新辅助化疗方案,这些方案可与手术治疗和/或放疗联合使用.根据这些临床研究的结果,多模式治疗被认为是局部晚期NSCLC患者的合适治疗方法.当术后发现淋巴结受累时,以顺铂为基础的辅助化疗可带来总体生存获益.最近,新辅助和/或辅助使用的免疫疗法增加顺铂为基础的化疗已被发现在许多大规模的临床试验中提高患者的生存率与局部晚期NSCLC;最佳治疗策略仍在不断发展。
    The perioperative treatments for non-small cell lung cancer (NSCLC) should control both local and microscopic systemic disease, because the survival of patients with NSCLC who underwent surgical resection alone has been dismal except in stage IA patients. One way to improve surgical outcome is the administration of chemotherapy before or after the surgical procedure. During the last two decades, many clinical studies have focused on developing optimal adjuvant or neoadjuvant cisplatin-based chemotherapy regimens that can be combined with surgical treatment and/or radiotherapy. Based on the results of those clinical studies, multimodality therapy has been considered to be an appropriate treatment approach for locally advanced NSCLC patients. When nodal involvement is discovered postoperatively, adjuvant cisplatin-based chemotherapy has conferred an overall survival benefit. More recently, neoadjuvant and/or adjuvant use of immunotherapy adding to the cisplatin-based chemotherapy has been revealed to improve survival of the patients with locally advanced NSCLC in many large-scale clinical trials; although, optimal treatment strategies are still evolving.
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  • 文章类型: Journal Article
    光动力疗法(PDT)是一种微创治疗方式,已在临床上用于早期和无法手术的癌症。文献中记载了这种无创伤疗法在骨坏死(ORN)和颌骨坏死(ONJ)中的成功使用。这篇综述的目的是系统评估光动力疗法在ORN和ONJ中的作用。
    两位独立的审阅者在PubMed中进行了精心的搜索,GoogleScholar和Cochrane的CENTRAL数据库在PDT上作为ORN/ONJ的独立或辅助治疗发表,直到2022年6月。本研究基于系统评价和荟萃分析的首选报告项目。人口统计数据,颌骨坏死的类型和阶段,site,PDT协议,评估愈合时间和随访时间。根据最终分析的纳入和排除标准,共纳入18篇文章。
    本综述共纳入94例患者,其中男性36例,女性58例。5项研究报道了在ORN中使用PDT作为辅助治疗。13项研究报告了ONJPDT的成功结果。86/94(91.48%)患者使用PDT±其他佐剂实现了完全上皮化。在本研究中,使用PDT治疗病变消退所需的时间为4天至12个月。
    综述的研究证明了PDT的有效性,作为辅助治疗,管理ORN和ONJ的各个阶段。
    UNASSIGNED: Photodynamic therapy (PDT) is a minimally invasive treatment modality that has been used clinically for early stage and inoperable cancers. Successful use of this atraumatic therapy in osteoradionecrosis (ORN) and osteonecrosis of the jaws (ONJ) has been documented in the literature. The aim of this review was to systematically evaluate the role of photodynamic therapy in ORN and ONJ.
    UNASSIGNED: Two independent reviewers conducted an elaborate search in PubMed, Google Scholar and Cochrane\'s CENTRAL database for studies published on PDT as stand-alone or adjuvant therapy in ORN/ONJ until June 2022. The present study was based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Demographic data, type and stage of necrosis of the jaws, site, PDT protocol, time to heal and follow-up were evaluated. Eighteen articles were included totally based on the inclusion and exclusion criteria for final analysis.
    UNASSIGNED: A total of 94 patients were included in the present review out of which 36 were males and 58 were females. Five studies reported the use of PDT as an adjuvant therapy in ORN. Thirteen studies reported successful outcomes with PDT in ONJ. Complete epithelialization was achieved with PDT ± other adjuvants in 86/94 (91.48%) patients. The time taken for regression of the lesion ranged between 4 days and 12 months with PDT in the present study.
    UNASSIGNED: The reviewed studies demonstrate the effectiveness of PDT, as an adjuvant therapy, in managing various stages of ORN and ONJ.
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  • 文章类型: Journal Article
    皮肤鳞状细胞癌(cSCC)是全球第二大最普遍的非黑色素瘤皮肤癌,约占所有皮肤恶性肿瘤的20%。确定其确切发生率带来了挑战;然而,报告显示其患病率在全球范围内增加。在诊断的时候,大多数CSCC都是本地化的,导致良好的5年治愈率超过90%。然而,一部分患者(3-7%)遭遇局部晚期或转移性cSCC,导致大量的发病率和死亡率。转移的风险范围为0.1%至9.9%,相关死亡风险为2.8%。影响复发的因素,转移,疾病特异性死亡率强调了神经周浸润(PNI)作为关键指标的重要性.PNI患者可能表现出PNI的临床症状和/或放射学体征,虽然大多数人没有症状,和PNI经常在组织学检查中被识别。尽管与其他癌症类型相比,其频率较低,PNI是公认的cSCC不良预后因素。手术是这些患者的选择性治疗,虽然辅助放疗(ART)的作用仍存在争议,尚未得到最终评估,特别是在清晰的手术边缘。需要进行前瞻性比较研究,以全面评估cSCC和PNI患者ART的益处和风险。
    UNASSIGNED: Cutaneous squamous cell carcinoma (cSCC) stands as the second most prevalent non-melanoma skin cancer worldwide, comprising approximately 20% of all cutaneous malignancies. Determining its precise incidence poses challenges; however, reports indicate a global increase in its prevalence. At the time of diagnosis, the majority of cSCCs are localized, resulting in favorable 5-year cure rates surpassing 90%. Nevertheless, a subset of patients (3-7%) encounters locally advanced or metastatic cSCC, leading to substantial morbidity and mortality. The risk of metastasis ranges from 0.1% to 9.9%, carrying an associated mortality risk of 2.8%. Factors influencing recurrence, metastasis, and disease-specific mortality underscore the significance of perineural invasion (PNI) as a key indicator. Patients with PNI may manifest clinical symptoms and/or radiologic signs of PNI, while the majority remain asymptomatic, and PNI is frequently identified upon histologic examination. Despite its lower frequency compared to other cancer types, PNI serves as a recognized adverse prognostic factor for cSCC. Surgery is the elective treatment for these patients, while the role of adjuvant radiotherapy (ART) is yet contentious and have not been conclusively assessed, particularly in clear surgical margin. Prospective comparative studies are required to comprehensively evaluate the benefit and the risks of ART for cSCC and PNI patients.
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  • 文章类型: Journal Article
    背景/目的:原发性阴道黑色素瘤(PVM)是一种罕见的癌症,占阴道癌的5%,占所有女性阴道黑色素瘤的不到1%,发病率为每年每百万妇女0.46。这项研究的目的是介绍一例年轻PVM患者的综合治疗和保守手术治疗,并对同一主题进行系统回顾。方法:我们对文献进行了叙述性回顾,并提出了一个病例报告。结果:共发表了43篇文献。我们介绍了治疗方式和生存结果。该病例涉及手术治疗与包括纳武单抗和伊匹单抗的辅助治疗相结合。结论:PVM是一种预后不良的疾病;然而,新的治疗方案是有希望的,并且很有可能显著提高生存率.原发性病变的广泛局部切除以及辅助治疗的组合在PVM的治疗中产生最佳结果。未来的临床研究有必要为非手术的治疗结果提供新的证据,转移性PVM和PVM的辅助治疗。
    Background/Objectives: Primary vaginal melanoma (PVM) is a rare cancer representing five percent of vaginal cancers and less than one percent of all female vaginal melanomas, with an incidence rate of 0.46 per million women per year. The aim of this study was to present a case of combined therapy and conservative surgical treatment in a young patient with PVM and to perform a systematic review of the same subject. Methods: We performed a narrative review of the literature and presented a case report. Results: The review yielded a total of 43 articles. We presented treatment modalities and survival outcomes. The presented case involved a combination of surgical treatment with adjuvant therapy comprising nivolumab and ipilimumab. Conclusions: PVM is a disease with a poor prognosis; however, new treatment options are promising and have a great chance of significantly improving survival. The combination of the wide local excision of the primary lesion followed by adjuvant therapies results in the best outcomes in the treatment of PVM. Future clinical studies are warranted to provide new evidence for the treatment outcomes of nonsurgical, metastatic PVM and the adjuvant treatment of PVM.
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  • 文章类型: Journal Article
    基于免疫检查点抑制剂(ICI)的治疗在各种癌症类型中取得了令人印象深刻的成功。近十年来,几种ICI被空前批准为晚期肝细胞癌(HCC)的治疗方案。同时,正在进行许多临床试验,以利用更多的ICIs进入最初不可切除的HCC和术后HCC,以预期诱导足够的肿瘤降级以进一步切除或实施辅助治疗以实现无复发生存。分别。在这次审查中,我们的目的是总结一些语用的组织形态学,免疫组织化学,和分子病理参数有望表明新辅助/转化ICI相关治疗的反应,并预测辅助/治疗性ICI相关治疗对HCC的疗效。
    我们使用术语肝细胞癌搜索PubMed,免疫疗法,免疫检查点抑制剂,免疫检查点封锁,转换疗法,新辅助治疗,辅助治疗,生物标志物,病理评估,病理评估至2023年2月。
    尽管对相关HCC标本的病理评估尚无共识,令人鼓舞的是,一些研究集中在这个领域,而且,其他类型癌症的方法和参数也值得参考。对于接受免疫治疗的HCC标本的病理评估,一个合适的抽样方案,识别免疫疗法相关的病理反应,应强调病理反应率的量化。对于计划接受免疫治疗的HCC患者,肿瘤浸润淋巴细胞,肿瘤内三级淋巴结构,程序性细胞死亡配体1,Wnt/β-catenin,微卫星不稳定性和错配修复,肿瘤突变负荷和肿瘤新抗原,以及其他一些信号通路是ICI治疗反应的潜在预测生物标志物。
    免疫治疗时代的HCC管理出现了一个全新的病理学挑战,即提供与免疫治疗相关的诊断报告。尽管许多相关研究是临床前或不足的,它们可能在未来极大地改变HCC的免疫治疗策略。
    UNASSIGNED: Immune checkpoint inhibitor (ICI)-based therapy has achieved impressive success in various cancer types. Several ICIs have been unprecedentedly approved as the treatment regimens for advanced hepatocellular carcinoma (HCC) in recent decade. Meanwhile, numerous clinical trials are being performed to exploit more ICIs into initially unresectable HCC and postoperative HCC to expectantly induce adequate tumor downstaging for further resection or implement adjuvant treatment for relapse-free survival, respectively. In this review, we aim to summarize some pragmatic histomorphologic, immunohistochemical, and molecular pathologic parameters which promisingly indicate the response of neoadjuvant/conversion ICI-related therapy and predict the efficacy of adjuvant/therapeutic ICI-related therapy for HCC.
    UNASSIGNED: We searched PubMed using the terms hepatocellular carcinoma, immunotherapy, immune checkpoint inhibitor, immune checkpoint blockade, conversion therapy, neoadjuvant therapy, adjuvant therapy, biomarker, pathologic evaluation, pathologic assessment till February 2023.
    UNASSIGNED: Although there is no consensus regarding the pathologic evaluation of relevant HCC specimens, it is encouraging that a few of studies have concentrated on this field, and moreover, the methods and parameters noted on other cancer types are also worthy of reference. For the pathologic assessment of HCC specimens underwent immunotherapy, a suitable sampling scheme, identifying immunotherapy-related pathologic response, and quantification of pathologic response rate should be emphasized. For the patients of HCC who are scheduled to receive immunotherapy, tumor-infiltrating lymphocyte, intratumoral tertiary lymphoid structure, programmed cell death ligand 1, Wnt/β-catenin, microsatellite instability and mismatch repair, tumor mutational burden and tumor neoantigen, as well as some other signaling pathways are the potential predictive biomarkers of treatment response of ICI.
    UNASSIGNED: The management of HCC in the era of immunotherapy arises a brand-new pathological challenge that is to provide an immunotherapy-related diagnostic report. Albeit many related researches are preclinical or insufficient, they may tremendously alter the immunotherapy strategy of HCC in future.
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  • 文章类型: Journal Article
    肝切除术后的辅助治疗对于表现出高风险复发因素的肝细胞癌(HCC)患者至关重要。免疫检查点抑制剂(ICIs)对不可切除的HCC有效;然而,其对该特定患者组的有效性和安全性仍不确定.
    我们在四个学术数据库中进行了广泛的文献检索,以确定相关研究。我们的主要终点是总生存期(OS),无复发生存率(RFS),和不良事件(AE)。OS和RFS使用风险比(HR)进行量化,而1-,2-,3年OS和RFS率表示为风险比(RRs)。此外,计算AE的发生率.
    我们的荟萃分析包括11项研究(N=3,219例患者),包括两项随机对照试验(RCT)和9项回顾性研究。其中,八项研究报告了OS的HR,在接受辅助ICIs的患者中,OS有统计学上的显着改善(HR,0.60;95%置信区间[CI],0.45-0.80;p<0.0001)。所有纳入的研究都报告了RFS的HR,表明佐剂ICIs(HR,0.62;95%CI,0.52-0.73;p<0.0001)。此外,汇总数据表明,使用辅助ICIs可提高1年和2年OS和RFS率。任何级别的不良事件发生率为0.70(95%CI,0.49-0.91),3级或以上不良事件发生率为0.12(95%CI,0.05-0.20)。
    辅助ICI治疗可以提高表现出高风险复发因素的HCC患者的OS和RFS率。具有可管理的AE。
    https://www.crd.约克。AC.uk/prospro/#recordDetailsPROSPERO,标识符CRD42023488250。
    UNASSIGNED: Administering adjuvant therapy following liver resection is crucial for patients with hepatocellular carcinoma (HCC) exhibiting high-risk recurrence factors. Immune checkpoint inhibitors (ICIs) are effective against unresectable HCC; however, their effectiveness and safety for this specific patient group remain uncertain.
    UNASSIGNED: We conducted an extensive literature search across four scholarly databases to identify relevant studies. Our primary endpoints were overall survival (OS), recurrence-free survival (RFS), and adverse events (AEs). OS and RFS were quantified using hazard ratios (HRs), whereas the 1-, 2-, and 3-year OS and RFS rates were expressed as risk ratios (RRs). Additionally, the incidence of AEs was calculated.
    UNASSIGNED: Our meta-analysis included 11 studies (N = 3,219 patients), comprising two randomized controlled trials (RCTs) and nine retrospective studies. Among these, eight studies reported HRs for OS, showing a statistically significant improvement in OS among patients receiving adjuvant ICIs (HR, 0.60; 95% confidence interval [CI], 0.45-0.80; p < 0.0001). All included studies reported HRs for RFS, indicating a favorable impact of adjuvant ICIs (HR, 0.62; 95% CI, 0.52-0.73; p < 0.0001). Moreover, aggregated data demonstrated improved 1- and 2-year OS and RFS rates with adjuvant ICIs. The incidence rate of AEs of any grade was 0.70 (95% CI, 0.49-0.91), with grade 3 or above AEs occurring at a rate of 0.12 (95% CI, 0.05-0.20).
    UNASSIGNED: Adjuvant ICI therapy can enhance both OS and RFS rates in patients with HCC exhibiting high-risk recurrence factors, with manageable AEs.
    UNASSIGNED: https://www.crd.york.ac.uk/prospero/#recordDetails PROSPERO, identifier CRD42023488250.
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  • 文章类型: Journal Article
    目的:在头颈部鳞状细胞癌(HNSCC)手术后6周内开始术后放疗(PORT)被纳入国家综合癌症网络临床实践指南,是癌症质量委员会的指标。与启动PORT延迟相关的因素尚未得到系统描述或综合。
    方法:PubMed,Scopus,和CINAHL。
    方法:我们纳入了描述人口统计学特征的研究,临床因素,2003年后在美国接受治疗的HNSCC患者与PORT延迟(>6周)相关的健康或社会决定因素。在非重叠数据集上进行比值比(ORs)的荟萃分析。
    结果:在回顾的716份独特摘要中,系统评价包括21项研究,荟萃分析包括15项。研究样本量为19至60,776例患者。在荟萃分析中,与港口延误相关的因素包括黑人种族(或,1.46,95%置信区间[CI]:1.28-1.67),西班牙裔种族(或,1.37,95%CI,1.17-1.60),医疗补助或没有医疗保险(或,2.01,95%CI,1.90-2.13),收入较低(或,1.38,95%CI,1.20-1.59),术后入院>7天(OR,2.92,95%CI,2.31-3.67),和30天医院再入院(或,1.37,95%CI,1.29-1.47)。
    结论:延迟启动遵循指南的PORT的风险最大的患者包括来自少数民族社区的患者,社会经济地位较低,并经历术后挑战。这些发现提供了提供有针对性的干预措施以提高HNSCC护理服务公平性和质量所需的基础证据。
    OBJECTIVE: Initiating postoperative radiotherapy (PORT) within 6 weeks of surgery for head and neck squamous cell carcinoma (HNSCC) is included in the National Comprehensive Cancer Network Clincal Practice Guidelines and is a Commission on Cancer quality metric. Factors associated with delays in starting PORT have not been systematically described nor synthesized.
    METHODS: PubMed, Scopus, and CINAHL.
    METHODS: We included studies describing demographic characteristics, clinical factors, or social determinants of health associated with PORT delay (>6 weeks) in patients with HNSCC treated in the United States after 2003. Meta-analysis of odds ratios (ORs) was performed on nonoverlapping datasets.
    RESULTS: Of 716 unique abstracts reviewed, 21 studies were included in the systematic review and 15 in the meta-analysis. Study sample size ranged from 19 to 60,776 patients. In the meta-analysis, factors associated with PORT delay included black race (OR, 1.46, 95% confidence interval [CI]: 1.28-1.67), Hispanic ethnicity (OR, 1.37, 95% CI, 1.17-1.60), Medicaid or no health insurance (OR, 2.01, 95% CI, 1.90-2.13), lower income (OR, 1.38, 95% CI, 1.20-1.59), postoperative admission >7 days (OR, 2.92, 95% CI, 2.31-3.67), and 30-day hospital readmission (OR, 1.37, 95% CI, 1.29-1.47).
    CONCLUSIONS: Patients at greatest risk for a delay in initiating guideline-adherent PORT include those who are from minoritized communities, of lower socioeconomic status, and experience postoperative challenges. These findings provide the foundational evidence needed to deliver targeted interventions to enhance equity and quality in HNSCC care delivery.
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  • 文章类型: Journal Article
    辅助免疫治疗的最新进展为改善高危膀胱癌(BC)和肾细胞癌(RCC)的无病生存率提供了希望。这篇综述集中在关键试验,如CheckMate274和KEYNOTE-564,这些试验显示了在BC中使用nivolumab和在RCC中使用pembrolizumab的有希望的结果。包括进展风险降低30%。Pembrolizumab还证明了RCC的总体生存(OS)益处。该综述还探讨了循环肿瘤DNA(ctDNA)作为更好的治疗选择和患者分层的生物标志物的潜力。它强调需要正在进行的研究来建立生存益处,并建议整合生物标志物和风险分层以优化BC和RCC的辅助免疫疗法。
    Recent progress in adjuvant immunotherapy offers hope for improving disease-free survival in high-risk bladder cancer (BC) and renal cell carcinoma (RCC). This review focuses on key trials such as CheckMate 274 and KEYNOTE-564, which show promising results with nivolumab in BC and pembrolizumab in RCC, including a 30% reduction in progression risk. Pembrolizumab also demonstrated overall survival (OS) benefit in RCC. The review also explores the potential of circulating tumor DNA (ctDNA) as a biomarker for better therapy selection and patient stratification. It emphasizes the need for ongoing research to establish survival benefits and suggests integrating biomarkers and risk stratification to optimize adjuvant immunotherapy in BC and RCC.
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  • 文章类型: Systematic Review
    目的:系统评价中药汤剂辅助治疗糖尿病肾病的有效性和安全性。方法:在PubMed中进行全面搜索,WebofScience,科克伦图书馆,Embase,中国国家知识基础设施(CNKI),和万方数据库,涵盖2013年1月至2023年7月期间。搜索仅限于在过去十年中进行的随机对照试验(RCT),该试验研究了使用中药汤剂作为糖尿病肾病的辅助治疗方法。对照组给予西医治疗,干预组在常规治疗的基础上加用中药汤剂。采用尾注和Excel进行文献管理和数据组织,使用Revman5.3和Stata16软件进行分析。结果:本研究纳入了66个RCTs,涉及6,951名参与者。中药汤剂辅助治疗糖尿病肾病的临床疗效明显高于对照组(OR=3.12,95%CI[2.70,3.60],I2=0%,p<0.00001)。干预组与对照组的不良事件发生率无显著差异(OR=0.94,95%CI[0.60,1.48],I2=0%,p=0.94)。根据肾功能和血糖指标的次要结局,与对照组相比,干预组显示出更好的治疗效果。最常用的中医类别是补药,活血药,收敛药,利尿药,清热药,和泻药。其中,前五名常用中药是黄芪[豆科;黄芪](58次),丹参[唇齿科;丹参](42次),山药[山药科;山药](38次),Poriacocos(Schw。)狼[猪科;Poria](38次),和山茱萸Siebold&Zucc。[山茱萸科;山茱萸](35倍)。结论:中药汤剂联合西药治疗糖尿病肾病可提高临床疗效,与单纯西药相比,最终排版文章没有达到更好的治疗效果,没有重大风险。系统审查注册:https://www。crd.约克。AC.uk/PROSPERO/#recordDetails,标识符[CRD42022529144]。
    Objective: This study aimed to assess the efficacy and safety of traditional Chinese medicine decoction as an adjunctive treatment for diabetic nephropathy in systematic evaluations. Methods: A comprehensive search was conducted in PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), and Wanfang databases, covering the period from January 2013 to July 2023. The search was restricted to randomized controlled trials (RCTs) conducted within the past decade that investigated the use of TCM decoction as an adjunctive treatment for diabetic nephropathy. The control group received western medicine treatment, while the intervention group received TCM decoction in addition to the conventional treatment. Endnote and Excel were employed for literature management and data organization, and Revman 5.3 and Stata 16 software were used for the analyses. Results: 66 RCTs involving 6,951 participants were included in this study. The clinical efficacy of TCM decoction as an adjunctive treatment for diabetic nephropathy was found to be significantly higher than that of the control group (OR = 3.12, 95% CI [2.70, 3.60], I2 = 0%, p < 0.00001). The incidence of adverse events did not differ significantly between the intervention group and the control group (OR = 0.94, 95% CI [0.60, 1.48], I2 = 0%, p = 0.94). According to the secondary outcomes of renal function and blood glucose indicators, the intervention group showed better therapeutic efficacy compared to the control group. The most frequently used TCM categories were tonifying medicine, blood-activating medicine, astringent medicine, diuretic medicine, heat-clearing medicine, and laxative medicine. Among them, the top five frequently used Chinese medicine were Astragalus mongholicus Bunge [Fabaceae; Astragali mongholici radix](58 times), Salvia miltiorrhiza Bunge [Lamiaceae; Radix et rhizoma salviae miltiorrhizae] (42 times), Dioscorea oppositifolia L. [Dioscoreaceae; Dioscoreae rhizoma] (38 times), Poria cocos (Schw.) Wolf [Polyporaceae; Poria] (38 times), and Cornus officinalis Siebold & Zucc. [Cornaceae; Corni fructus] (35 times). Conclusion: The combined use of TCM decoction with western medicine in the treatment of diabetic nephropathy can enhance clinical effectiveness and 2 This is a provisional file, not the final typeset article achieve superior therapeutic effects in comparison to western medicine alone, without significant risks. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/#recordDetails, identifier [CRD42022529144].
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