Effect of Traditional Chinese Medicine Injection on Cancer-Related Fatigue: A Meta-Analysis Based on Existing Evidence

Abstract

Background and Objective. Cancer-related fatigue (CRF) is a common and painful side effect for cancer patients. The treatment of CRF by traditional Chinese medicine injection (TCMJ) is controversial. We conducted a meta-analysis and systematic review to evaluate the effect of TCMJ on CRF, with a view to providing some guidance for clinical application. Methods. We systematically searched randomized controlled studies reported through March 2020 in PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, Web of Science, China Biomedical Literature Database (CBM), the China National Knowledge Infrastructure (CNKI), Wanfang, and VIP databases. Two investigators independently screened the studies according to the predetermined criteria, extracted data, and evaluated the bias risk of the included studies, using RevMan5.3 software. Results. Twelve studies enrolling 1005 participants were included in this systematic review. We found that TCMJ could improve the clinical efficacy of CRF patients (RR = 1.24, 95% CI: 1.05–1.46, $P=0.01$ ), ameliorate fatigue status (RR = 1.44, 95% CI: 1.27–1.65, $P<0.00001$ ), and improve quality of life (MD = 8.34, 95% CI: 3.31–13.37, $P=0.001$ ), but there was no statistical significance in the fatigue score (MD = −1.10, 95% CI: −2.23–0.04, $P=0.06$ ). Referring to the number of adverse events, the safety of TCMJ was good. Subgroup analysis showed that TCMJ could improve clinical efficacy, fatigue, and quality of life in a short time (≤4 weeks). Among them, tonic TCMJ could improve the clinical efficacy. TCMJ had advantages in improving fatigue of lung cancer and gastric cancer. In addition, life quality of lung cancer patients improved significantly. Conclusion. Current research evidence showed that TCMJ could improve the clinical efficacy, fatigue status, and life quality of patients with CRF. In addition, we found that TCMJ could improve the clinical efficacy of CRF patients in a short period of time. Tonic TCMJ could improve the clinical efficacy, but heat-clearing TCMJ could not. Life quality and fatigue status of lung cancer patients improved significantly. However, due to the sample size and quality of the included studies, the results of this analysis should be treated with caution. The above conclusions still need to be verified by more large-sample and high-quality randomized controlled trials.