中医药维持治疗中晚期非小细胞肺癌的系统评价

Systematic review and Meta-analysis on advance non-small cell lung cancer in the maintenance treatment with Chinese herbal medicine

目的对中医药作为非小细胞肺癌维持治疗的一种治疗手段的疗效进行系统评价,并就中医药同质性不同,分为中药煎剂、中成药分别进行Meta分析。方法通过对国内外搜索引擎:Pubmed、Sinomed数据库、CNKI数据库、万方、维普、Cochrane Library、EBASE等搜索,时间范围从建库起至2017年8月18日,严遵纳入排除标准选择文献,提取资料,质量评估和Meta分析,由Rev Man5. 3软件执行。终点指标为PFS(无疾病进展期)、生活质量(行为状态KPS评分)。结果纳进23项研究,共1668例患者。根据Cochrane质量评价表,A级0篇,B级13篇,C级10篇。PFS的Meta分析结果:中晚期非小细胞肺癌一线化疗后未进展患者应用中医药维持治疗可延长PFS。KPS评分Meta分析结果:中医药干预组可改善维持阶段的NSCLC患者生活质量。结论在非小细胞肺癌维持治疗阶段中应用中医药,具有延长生存期,改善生活质量的作用。

Objective To carry out the systematic review on the therapeutic effects on non-small cell lung canc-er(NSCLC)in the maintenance treatment with TCM and the Meta-analysis was done on Chinese herbal decoction and Chinese patents in terms of the different homogeneity of Chinese herbal medicine.Methods The data were retrieved from Pubmed,Sinomed,CNKI,Wanfang,VIP,Cochrane Library and EBASE databases from the time of establishment to August18,2017.The articles were selected strictly based on the eligible criteria.RevMan5.3software was adopted for the data extraction and quality assessment.The endpoints were PFS(progression free survival)and living quality(KPS score).Results A total of23studies were included,with1668patients.According to Cochrane assessment scale,0article was of A grade,13articles of B grade and10articles of C grade.The Meta-analysis of PFS showed that for the cases ofⅢB/ⅣNSCLC patients without progression after the first-line chemotherapy,Chinese herbal medicine prolonged PFS.KPS scale indicated that Chinese herbal medicine intervention improved the living quality of NSCLC patients at the maintenance stage.Conclusion In the treatment of NSCLC at the maintenance stage,Chinese herbal medicine can prolongs the survival span and improves the living quality.