基于Meta分析的参苓白术散加减辅助治疗肺癌综合疗效系统评价

Systematic Evaluation of Comprehensive Efficacy of Shenling Baizhu Powder(参苓白术散)as Adjuvant Therapy for Lung Cancer Based on Meta-Analysis

目的系统评价参苓白术散加减辅助治疗肺癌的综合治疗效果。方法计算机检索中国知网(CNKI)、重庆维普数据库(VIP)、万方数据库(WanFang Data)、国家科技图书文献中心(NSTL)、中国生物医学数据库(CBM)、The Cochrane Library、Pub Med、EM base,搜索纳入比较单用参苓白术散加减或参苓白术散加减联合对照组与对照组其他疗法的随机对照试验(RCT),检索时限均从建库至2019年11月7日。由2名研究者按照纳排标准筛选文献、评价文献质量、评估偏倚风险、提取文献基本资料,采用RevMan 5.3软件进行Meta分析。结果共纳入10项RCTs,共709例患者,其中对照组354例,试验组355例。Meta分析结果显示:参苓白术散加减辅助治疗肺癌与对照组相比可提高肺癌的临床疗效有效率[RR=1.85,95%CI(1.39,2.45),P<0.0001],可改善生活质量[RR=1.85,95%CI(1.39,2.45),P<0.0001],可提升中医证候疗效[RR=1.60,95%CI(1.18,2.16),P=0.002],同时可缓解化疗后不良反应如恶心呕吐[RR=2.02,95%CI(1.54,2.65),P<0.00001]以及腹泻[RR=1.35,95%CI(1.11,1.71),P=0.004]。结论基于以上分析,临床治疗肺癌使用参苓白术散加减辅助治疗具有良好治疗效果,在提高临床有效率、改善生活质量、提升中医证候疗效、缓解恶心呕吐及腹泻等化疗不良反应上有优势。但由于纳入文献质量偏低、报告结局指标较少等缺点,无法全面准确分析治疗效果,还需进行更高质量的临床研究,以期为肺癌临床中西医治疗提供可靠证据支持。

Objective To systematically evaluate the comprehensive effect of Shenling Baizhu Powder(参苓白术散) as the adjuvant therapy for lung cancer.Methods CNKI,VIP,WanFang Data, NSTL,CBM,The Cochrane Library and PubMed were electronically searched to collect randomized controlled trials(RCTs) on systematic evaluation of comprehensive efficacy of Shenling Baizhu Powder as adjuvant therapy for lung cancer from inception to November 7,2019.Two researchers selected the literature according to the criteria, evaluated the quality of the literature, assessed the risk of bias, extracted the basic data of the literature, and conducted Meta-analysis using RevMan5.3 software.Results A total of 10 RCTs were included.There were 709 patients, including 354 in the control group and 355 in the experimental group.The results of Meta-analysis showed that Shenling Baizhu Powder as adjuvant therapy for lung cancer can improve the clinical efficacy[RR=1.85,95%CI(1.39,2.45),P<0.0001],the quality of life[RR=1.85,95%CI(1.39,2.45),P<0.0001] and the efficacy of TCM syndrome[RR=1.60,95%CI(1.18,2.16),P=0.002],alleviate adverse reactions after chemotherapy such as nausea and vomiting [RR=2.02,95%CI(1.54,2.65),P<0.00001] and diarrhea[RR=1.35,95%CI(1.11,1.71),P=0.004] compared with the control group.Conclusion Based on the above analysis, the clinical treatment of lung cancer with Shenling Baizhu Powder as adjuvant therapy has a good therapeutic effect on improving clinical efficiency, quality of life and TCM syndrome efficacy, relieving nausea, vomiting and diarrhea and other adverse reactions due to chemotherapy.However, due to the shortcomings of low literature quality and low reporting outcomes, it is impossible to comprehensively and accurately analyze the treatment effect.Higher quality clinical research is needed to provide reliable evidence for the clinical treatment of lung cancer.