Efficacy and safety of integrated Chinese and western medicine for cancer therapy-induced thrombocytopenia: A meta-analysis

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Abstract

Objective

To evaluate the efficacy and safety of Traditional Chinese medicine (TC M) combined with Western medicine (WM) for cancer therapy-induced thrombocytopenia (CTIT).

Methods

A comprehensive literature search was performed across multiple databases, including PubMed, Embase, Cochrane Library, China biology medicine, China national knowledge infrastructure, Wanfang, and VIP, from inception to August 2025. Randomized controlled trials (RCTs) examining the effects of integrated TCM and WM on CTIT were included. The primary outcomes were significant response rate and overall response rate, while secondary outcomes included nadir platelet count, duration of thrombocytopenia, and adverse events. The methodological quality of the included RCTs was assessed using the Cochrane Risk of Bias Tool (version 5.1.0).

Results

A total of 33 studies involving 2,443 patients were included, comprising 1,204 patients in the experimental group and 1,186 in the control group. All studies were conducted in China and published between 2004 and 2024. Compared with WM alone, integrated TCM and WM significantly improved overall response r ate (risk ratio [RR] = 1.40, 95% confidence interval [CI]: 1.14-1.73), increased plate let counts (RR = 13.59, 95% CI: 11.01-16.17), shortened the duration of thrombocytopenia (MD = -3.46, 95% CI: -4.30 to -2.63), and reduced the incidence of adverse events (RR = 2.34, 95% CI: 1.52-3.6).

Conclusions

In conclusion, combined TCM and WM demonstrates significant benefits in alleviating CTIT, elevating platelet counts, reducing thrombocytopenia duration, and minimizing side effects associated wit h thrombopoietic therapies compared to WM alone.

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