益气化痰法对NSCLC含铂类化疗方案增效减毒的Meta分析

Meta-analysis of the Efficacy Enhancing and Toxicity Reducing of Platinum Containing Chemotherapy Scheme for NSCLC by the Method of Benefiting Qi and Dissipating Phlegm

目的评价益气化痰法对非小细胞肺癌(non-small cell lung cancer,NSCLC)含铂类化疗方案增效减毒的临床疗效。方法计算机检索国内外中文和英文数据库,检索时间限定为建库至2019年10月31日,收集所有具有益气化痰功效的中药复方治疗NSCLC的临床随机对照试验,由两名研究者独立进行文献筛选、资料提取及质量评价后,采用Revman 5.3软件进行Meta分析。结果最终纳入文献6篇,共525例患者。Meta分析结果显示:与对照组(单用含铂类化疗治疗)相比,治疗组(益气化痰方药联合含铂类化疗治疗)可有效稳定肺癌病灶、控制肿瘤进展、提高患者生活质量、降低肿瘤标志物表达水平、改善临床症状(咳嗽)、减轻化疗后副反应(白细胞减少、血红蛋白减少及消化道反应减少),上述各项结局指标的差异均有统计学意义(P<0.05)。结论益气化痰法治疗NSCLC安全有效,其与含铂类化疗方案联用具有增效减毒的协同优势,可有效提高铂类方案的临床疗效,降低毒副作用,值得进一步推广应用。

Objective To evaluate the clinical effects of the method of benefiting Qi and dissipating phlegm in the efficacy enhancing and toxicity reducing of platinum containing chemotherapy scheme for non-small cell lung cancer(NSCLC).Methods Chinese and English databases in China and abroad were searched by computer.The searching time was limited from database establishment to October 31,2019.Clinical randomized controlled trials of Chinese herbal compound prescriptions with effects of benefiting Qi and dissipating phlegm on NSCLC were collected.After literature screening,data extraction and quality evaluation were performed by two researchers independently.Revman 5.3 software was used for meta-analysis.Results Totally 6 papers were included in the literature,with a total of 525 patients.Meta-analysis results showed that compared with the control group(platinum containing chemotherapy scheme alone),the treatment group(Yiqi Huatan Formula+platinum containing chemotherapy scheme)can effectively stabilize lung cancer focus,control tumor progress,improve patients'quality of life,reduce tumor markers,improve clinical symptoms(cough),and reduce side effects(leukopenia,hemoglobin reduction and gastrointestinal reaction)after chemotherapy;the differences of the above outcome indicators were statistically significant(P<0.05).Conclusion It is safe and effective to treat NSCLC with the method of benefiting Qi and dissipating phlegm.It has the synergetic advantage of efficacy enhancing and reducing toxicity with platinum containing chemotherapy scheme.It can effectively improve the clinical efficacy of the platinum plan and reduce the toxic and side effects.It is worthy of further promotion and application.