中医药联合化疗治疗晚期非小细胞肺癌的Meta分析

Meta-Analysis of Traditional Chinese Medicine in Treatment of Advanced Non Small Cell Lung Cancer

目的：对国内已发表的中医药联合化疗治疗晚期非小细胞肺癌（NSCLC）的效果进行系统评价,探讨其治疗NSCLC的安全性及有效性。方法：通过计算机文献检索CNKI、VIP、万方数据库2000—2016年间发表的有关中医药治疗晚期非小细胞肺癌的相关文献,对符合纳入标准的文献资料利用Review Manager 5.2软件进行Meta分析。结果：对最终纳入的10篇文章进行Meta分析,结果显示,与对照组相比,试验组可有效提高患者的临床近期疗效[OR=2.03,95%CI（1.10,3.76）,P=0.02]、改善患者生存质量[OR=0.17,95%CI（0.12,0.23）,P〈0.00001];在不良反应方面,Meta分析结果显示,试验组较与对照组在降低血小板计数发生率[OR=-0.08,95%CI（-0.13,-0.03）,P=0.002]、肝功能损害发生率[OR=-0.17,95%CI（-0.31,-0.04）,P=0.01]方面差异显著、具有统计学意义,但在降低白细胞计数发生率[OR=-0.03,95%CI（-0.11,0.06）,P=0.51]、贫血发生率[OR=-0.06,95%CI（-0.13,0.01）,P=0.10]方面两组差异不显著、不具有统计学意义。结论：中医药联合化疗治疗晚期NSCLC较单纯化疗能明显提高患者近期疗效、减轻不良反应、改善生存质量,具有较高临床应用价值。然而,由于文献样本量较少,尚需进一步研究。

Objective： To discuss the efficacy of traditional Chinese medicine in the treatment of advanced non small cell lung cancer（ NSCLC） and investigate the safety and efficacy of NSCLC in the treatment of advanced non-small cell lung cancer.Methods： Through the computer document retrieval CNKI,VIP,WANFANG database from 2000 until 2016 on the relevant literature on the treatment of advanced non small cell lung cancer with Chinese medicine and then Meta-analysis was performed by using Manager Review 5. 2 software to meet the inclusion criteria. Results： Meta-analysis was performed on the final 10 articles and the results showed that compared with the control group,the experimental group could effectively improve the clinical efficacy[OR = 2. 03,95% CI（ 1. 10,3. 76）,P = 0. 02],improve the quality of life [OR = 0. 17,95% CI（ 0. 12,0. 23）,P〈0. 00001]. In terms of adverse reactions,Meta-analysis showed that the experimental group compared with control group in reducing the incidence of platelet count [OR =-0. 08,95% CI（-0. 13,-0. 03）,P = 0. 002]and liver of function damage rate [OR =-0. 17,95% CI（-0. 31,-0. 04）,P = 0. 01]）. The difference was significant,but the decrease in white blood cell count of the incidence rate was not significant[OR =-0. 03,95% CI（-0. 11,0. 06）,P = 0. 51 ]）. The incidence of anemia（ [OR =-0. 06,95% CI（-0. 1,30. 01）,P = 0. 10]） in the two groups had no significant difference. Conclusion： Traditional Chinese medicine in the treatment of advanced NSCLC compared with chemotherapy alone can significantly improve the short-term efficacy,reduce adverse reactions,improve the quality of life,and has a high clinical value. However,due to the small sample size,it needs to be further studied.