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

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

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).

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).

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. Competing Interest Statement The authors have declared no competing interest. Funding Statement This study did not receive any funding. Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data Availability All data produced in the present work are contained in the manuscript