软坚散结法治疗非小细胞肺癌的疗效及安全性的Meta分析

Efficacy and safety of resolving hard lump for non-small cell lung cancer: A Meta-analysis

[目的]系统评价软坚散结方药治疗非小细胞肺癌(NSCLC)的有效性和安全性。[方法]计算机检索中文全文期刊数据库、万方数据库、中国生物医学文献数据库及PubMed、Embase、The Cochrane Library数据库,搜集软坚散结方药治疗非小细胞肺癌的临床随机对照试验(RCT),检索时限均为建库至2017年10月16日。由2位评价员独立筛选文献、提取资料并评价纳入文献的方法学质量,采用Stata 12.0软件进行统计分析。[结果]共纳入40个RCT共计3 201例NSCLC患者,涉及汤剂、丸剂、胶囊、合剂、注射剂5种剂型,34种干预措施。Meta分析结果显示,与单纯化疗药相比,软坚散结方药联合化疗药可提高NSCLC患者的临床疗效,改善患者的生活质量,延长NSCLC患者无进展生存期,降低化疗药物不良反应。[结论]软坚散结方联合化疗药的临床疗效、生存质量及降低不良反应方面优于单纯的化疗组。由于纳入研究质量较低,该结论仍需开展高质量研究进行验证。

[Objective] This systematic review aims to systematically evaluate the efficacy and safety of resolving hard lump on the treatment of non-small cell lung cancer(NSCLC).[Methods] We searched CNKI datebases,WanFang,SinoMed,PubMed,Embase,The Cochrane Library from the inception to October 16th 2017,to collect randomized controlled trials (RCTs)of the resolving hard lump in treating NSCLC.Two reviewers independently screened literature,extracted date and assessed the methodological quality of included studies.Then,statistical analysis was performed by using Stata12.0 and WinBUGS1.4.3 sofware.[Resluts] A total of 40 RCTs nvolved 3201 patients were finally included,in which 5 different dosage forms and 34 interventions.There mainly were decoction,pill,capsule,mixture,and injection.The result of direct Meta-analysis showed that compared with the simple chemotherapy group,resolving hard lump prescription combined with chemotherapeutic drugs could significantly improve the clinical efficacy,improve the quality of life of patients,prolong progression free survival and decrease adverse reactions of chemotherapeutic drugs.[Conclusion] Resolving hard lump prescription combined with chemotherapeutics were more effective than the simple chemotherapy group in terms of clinical efficacy,the quality of life,and decrease adverse reactions.Due to the low quality of included studies,more high quality RCTs are needed to verify the above conclusion.