[Evidence map for randomized controlled trials of traditional Chinese medicine in prevention and treatment of colorectal cancer].

Abstract

This study systematically reviewed the literature on the prevention and treatment of colorectal cancer(CRC) with traditional Chinese medicine(TCM), aiming to present a more intuitive and concise overview of existing evidence. Four major Chinese databases, including CNKI, Wanfang, VIP, and SinoMed, were searched for randomized controlled trial(RCT) on TCM treatment of CRC. The retrieval period was from database inception to August 1, 2023. The evidence was presented using a combination of text and charts. A total of 1 778 RCTs were included, and the overall publication volume showed an upward trend. The quality of the RCT was generally low, with sample sizes concentrated between 60 and 100 cases. The intervention durations were mainly 4, 8, and 12 weeks. Keywords primarily focused on advanced CRC, postoperative CRC, immune function, and gastrointestinal function. Clinical complications were often caused by surgery or chemotherapy, including intestinal obstruction, peripheral neuropathy, diarrhea, and anxiety and depression. There were various intervention measures, including TCM decoctions, TCM injections, Chinese medicine nursing, Chinese patent medicines, and acupuncture. Among them, TCM decoctions(excluding self-made prescriptions) included Shenling Baizhu Powder(32 articles, 1.80%) and Sijunzi Decoction(22 articles, 1.24%). TCM injections included Fufang Kushen Injection(54 articles, 3.04%) and Aidi Injection(46 articles, 2.59%). Chinese patent medicines included Cinobufacin Capsules(16 articles, 0.90%) and Fufang Banmao Capsules(10 articles, 0.56%). The outcome indicators were divided into 13 domains, including recent efficacy, quality of life, safety events, and TCM syndrome/symptom scores. The existing outcome indicators mostly followed the western medicine evaluation system, with complex types and no unified standards, lacking outcome indicators or scales with TCM characteristics, and relatively insufficient attention to long-term efficacy, anxiety, and depression. Future research should optimize clinical study designs, build a core index set and clinical evaluation system with TCM characteristics, and produce more high-level evidence to support the safety and effectiveness of TCM in preventing and treating CRC.