健脾化痰类中药联合化疗治疗非小细胞肺癌Meta分析

An Meta-Analysis of Treatment of Non-Small Cell Lung Cancer with TCM for Invigorating Spleen and Resolving Phlegm Combined with Chemotherapy

目的:系统评价健脾化痰类中药联合化疗对非小细胞肺癌的临床疗效。方法:计算机检索中国知网、万方数据库、维普资讯中文期刊平台等数据库,收集健脾化痰类中药联合化疗非小细胞肺癌的期刊文献,筛选并评价文献质量,提取相关数据,采用Revman 5.3进行Meta分析。结果:共纳入12个临床随机对照研究,其中健脾化痰类中药联合化疗组492例,单纯化疗组486例,Meta分析结果显示,中药联合化疗组的近期疗效[RR=1.44,95%CI(1.24,1.67),P<0.000 01]优于单纯化疗组,恶心呕吐的发生率[RR=0.56,95%CI(0.49,0.64),P<0.000 01]、白细胞数目减少的发生率[RR=0.72,95%CI(0.65,0.79),P<0.000 01]及血小板数目减少的发生率[RR=0.61,95%CI(0.51,0.72),P<0.000 01]皆低于单纯化疗组。结论:健脾化痰类中药联合化疗治疗非小细胞肺癌,可以提高近期疗效,降低消化道反应、骨髓抑制等不良反应的发生率,起到增效减毒的效果。

Objective:To systematically evaluate the clinical efficacy of TCM for invigorating spleen and resolving phlegm combined with chemotherapy on non-small cell lung cancer.Methods:The journal literatures of spleen-invigorating and phlegm-resolving TCM combined with chemotherapy for non-small cell lung cancer(NSCLC) were collected by computer searching the databases of China HowNet,Wanfang database and Weipu Information Chinese Journal Platform.The qualities of the literatures were screened and evaluated,and the relevant data were extracted.Revman 5.3 was used for Meta-analysis.Results:A total of 12 randomized controlled clinical trials were included,including 492 cases in the spleen-invigorating and phlegm-resolving TCM combined chemotherapy group and 486 cases in the simple chemotherapy group.Meta-analysis showed that the short-term efficacy of TCM combined with chemotherapy group [RR=1.44,95%CI(1.24,1.67),P<0.000 01] was better than that of chemotherapy alone group.Its incidence of nausea and vomiting [RR=0.56,95%CI(0.49,0.64),P<0.000 01];the incidence of leucopenia [RR=0.72,95%CI(0.65,0.79),P<0.000 01] and the reduction of platelet count [RR=0.61,95%CI(0.51,0.72),P<0.000 01)] were all lower than those of the simple chemotherapy group.Conclusion:TCM for invigorating spleen and resolving phlegm combined with chemotherapy has a remarkable efficacy on non-small cell lung cancer,can improve the short-term curative effect,reduce the incidence of adverse reactions such as digestive tract reaction and bone marrow suppression,and play a synergistic and detoxifying effect.