加速康复外科联合中医治疗在结直肠癌患者中应用的Meta分析
Application of Enhanced Recovery after Surgery Combined with TCM Therapy in Colorectal Cancer: A Meta-Analysis

目的：系统评价加速康复外科(Enhanced Recovery after Surgery, ERAS)理念联合中医治疗在腹腔镜结直肠癌根治术围手术期中的应用价值。方法：通过计算机检索国内外数据库中有关ERAS联合中医治疗对患者的随机对照试验(RCT)文献，截至2023年3月。由2位独立审查者进行文献筛选、资料数据收集及文献质量评价，运用RevMan 5.4版本进行数据分析。结果：纳入15篇RCT文献以ERAS围手术期管理为对照，共有1266例，Meta分析结果显示：ERAS结合中医治疗相比于ERAS围手术期管理可显著减少术后首次排气排便时间、术后住院时间、术后住院费用(P < 0.05)。ERAS结合中医治疗相比于ERAS围手术期管理可以减少腹胀的发生(P < 0.05)，而在术后其他胃肠道并发症、泌尿系并发症、术后感染、吻合口瘘、肺栓塞、发热、头晕、皮下淤血等方面，ERAS结合中医治疗未体现具有统计学差异的优势(P > 0.05)。结论：ERAS结合中医治疗可促进术后胃肠功能恢复，且安全性较好，由于可用的研究数量少及其潜在的异质性，上述结论仍需更多的高质量研究进行验证。
Objective: To evaluate the influence of enhanced recovery after surgery (ERAS) combined with TCM therapy for postoperative recovery of colorectal cancer by meta-analysis. Methods: Through searched major domestic and foreign databases to collect the literatures of randomized controlled trial (RCT) about enhanced recovery after surgery combined with Traditional Chinese Medicine therapy in colorectal cancer published by March, 2023. Two independent reviewers conducted literature screening, data collection and quality evaluation, and used RevMan 5.4 version for data analysis. Results: 15 RCT literatures with 1266 patients were involved. The Meta-analysis showed that ERAS combined with TCM therapy has significant advantages compared with perioperative management of ERAS in the time after surgery about first exhaust, first defecation, hospital stay and hospital expenses (P < 0.05). Compared with ERAS combined with TCM therapy has significant advantages in reduction of the occurrence of postoperative bloating (P < 0.05). About postoperative complications, urinary complications, postoperative infection, anastomotic leakage, pulmonary embolism, fever, dizziness, subcutaneous congestion, ERAS combined with TCM therapy has not statistically significant advantages compared with perioperative management of ERAS (P > 0.05). Conclusion: Compared with the perioperative management of ERAS, ERAS combined with TCM treatment can promote the recovery of postoperative gastrointestinal function and has a better safety profile. Due to the small number of available studies and their potential heterogeneity, more high-quality studies are needed to validate these conclusions.