A Meta-Analysis of Treating Radiation Proctitis by Retention Enema with Integrated Traditional Chinese and Western Medicine

Objective: To systematically and objectively evaluate clinical efficacy of retention enema with integrated traditional Chinese and western medicine on radiation proctitis（RP）. Methods: CNKI, WANFANG, VIP, CMB and foreign language databases like Embase, Central and Medline were searched. Search dates were from establishment of the databases until May 2020. Randomized controlled trials（RCTs） of retention enema with integrated traditional Chinese and western medicine for RP were retrieved. Two system reviewers selected literature materials, extracted literature data, and evaluated the quality of the literatures. RevMan 5.3 software was used for data analysis. Results: A total of 12 studies were included, including 941 patients. Meta-analysis results showed: Clinical efficacy in the retention enema group with integrated traditional Chinese and western medicine was better than that in the simple western medicine enema or blank enema group（OR=5.96, 95% CI [5.50, 14.29], P<0.000 01）. Improvement of abdominal pain in the retention enema group with integrated traditional Chinese and western medicine was better than that in the control group（MD=-0.57, 95% CI [-0.72,-0.42], P<0.000 01）. Treatment for hematochezia in the retention enema group with integrated traditional Chinese and western medicine was better than that in the control group（MD=-0.55, 95% CI [-0.69,-0.42], P<0.000 01）. Improvement of diarrhea in the retention enema group with integrated traditional Chinese and western medicine was better than that in the control group（MD=-0.69, 95% CI [-0.91,-0.48], P<0.000 01）. KPS scores in the retention enema group with integrated traditional Chinese and western medicine were better than those in the control group（MD=11.91, 95% CI [3.81, 20.01], P<0.000 01）. Conclusion: Clinical efficacy of retention enema with integrated traditional Chinese and western medicine on RP is better than simple western medicine enema or blank enema. Due to the low quality of the included clinical literatures, it is necessary to carry out more deliberate, detailed, high-quality, randomized, double-blind, and multi-center RCTs in order to give more powerful demonstration on its clinical efficacy on RP.