补益类中药对放射性肺炎预防作用的系统评价

Preventive Effect of Tonic Chinese Medicine on Radiation Pneumonia: A Systematic Reviews

目的评价补益类中药对胸部放疗并发放射性肺炎的预防作用。方法通过Meta分析的方法,制定检索策略,对Pubmed、Cochrane Library、Embase、中国知网(CNKI)、中国生物医学文献数据库(CBM)、维普网(VIP)、万方数据库等常用中英文数据库进行检索,检索时间为从建库至2017年6月1日。应用Revman5.0对纳入研究进行方法学质量评价,应用stata12.0对提取的主要指标放射性肺炎的发生情况及辅助指标进行分析。结果共纳入64篇文献,共5354例患者,研究方法学质量中度偏倚风险。与对照组相比,补益药能有效的预防放射性肺炎的发生(RR=0.529,95%CI(0.473,0.592),Z=11.17,P=0.000),并且能降低放射性肺纤维化的形成(RR=0.418,95%CI(0.339,0.516),Z=8.14,P=0.000),提高患者的生活质量(RR=1.668,95%CI(1.444,1.927),Z=6.96,P=0.000)。亚组分析及回归分析显示预防效果与使用补益药的种类、是否同步化疗、用药时程、患者的肿瘤类型及平均年龄无关。结论补益类中药可有效预防放射性肺炎及放射性肺纤维化的发生,并改善患者的生活质量。

Objective To evaluate the preventive effect of traditional Chinese medicine on the radiation pneumonia.Methods By means of Meta-analysis,A computer-based online search of PubMed,EMBASE and the Cochrane Library,and CNKI,CBM,Wanfang were conducted.The time is from the database establishment to June 1,2017.Through Revman 5.0 to assess the bias of the included studies,stata 12.0 was used to evaluate the extraction of the incidence of radiation pneumonitis and auxiliary indicators.Results A total of 64 studies involving 5354 patients were included,and methodological quality had moderate bias.Compared with the control group,Chinese medicine effectively prevented radioactive pneumonia(RR=0.529,95%CI(0.473,0.592),Z=11.17,P=0.000),and reduced the occurrence of radiation-induced lung fibrosis(RR=0.418,95%CI(0.339,0.516),Z=8.14,P=0.000),improved the quality of life of patients(RR=1.668,95%CI(1.444,1.927),Z=6.96,P=0.000).Sub analysis group analysis and regression analysis showed that the preventive effect was independent of the type of drug used,concurrent chemotherapy,duration of the medication,and the patient’s tumor type and age.Conclusion The traditional Chinese medicine can effectively prevent the occurrence of radioactive pneumonia and the occurrence of radiological pulmonary fibrosis,and improve the quality of life of the patients.