中医外治法治疗肺癌相关性咳嗽临床疗效的Meta分析

Meta-analysis on Clinical Efficacy of Traditional Chinese Medicine External Therapy for treatment of Lung Cancer-related Cough

目的系统评价中医外治法治疗肺癌相关性咳嗽的临床疗效。方法计算机检索中国知网(CNKI)、维普中文科技期刊全文数据库(VIP)、万方数据库(Wanfang Data)、中国生物医学数据库(SinoMed)、Embase、Cochrane图书馆及Pubmed数据库中中医外治法治疗肺癌相关性咳嗽的随机对照试验文献,文献发表时间为建库至2022年2月28日。采用相对危险度(relative risk,RR)或均数差(mean difference,MD)及对应的95%置信区间(confidence interval,CI)作为效应量指标。使用Cochrane风险偏倚评估工具进行文献质量评价,使用RevMan 5.4及Stata 14.0软件进行数据分析。结果本研究共纳入8篇文献,研究对象723例,其中试验组362例,对照组361例。Meta分析结果显示,与对照组相比,试验组可提高总有效率[RR=1.30,95%CI(1.09,1.55),P=0.004],可提高LCQ评分[WMD=2.97,95%CI(2.36,3.58),P<0.00001],可降低VAS评分[WMD=-1.63,95%CI(-3.16,-0.09),P<0.00001],可降低咳嗽症状积分[WMD=-0.93,95%CI(-1.09,-0.77),P<0.00001]。共报告3例不良反应/事件,均为轻度不良反应。结论与单纯使用西医常规治疗相比,单纯采用中医外治或中医外治联合常规西医治疗肺癌相关性咳嗽能够获得更好的临床疗效,能更好地改善患者临床症状,提高患者生活质量,且安全性较好。

Objective To systematically evaluate the clinical efficacy of traditional Chinese medicine(TCM)external therapy for treatment of lung cancer-related cough.Methods The literature of randomized controlled trials(RCTs)of lung cancer-related cough treated by TCM external therapy was retrieved from databases including Chinese National Knowledge Infrastructure(CNKI),Chinese Science and Technology Journal Database(VIP),Wanfang Data,Chinese Biomedical Literature Service System(SinoMed),Embase,Cochrane Library,and Pubmed.The collected literature was published from the establishment of each database to February 28,2022.Relative risk(RR)and mean difference(MD)with 95%confidence interval(CI)were used as the effect quantity indicators.The quality of the included literature was evaluated with Cochrane risk assessment manual.RevMan 5.4 and Stata 14.0 were used for statistical analysis.Results A total of 8 articles were included into the study,involving 723 patients,with 362 patients in the experimental group and 361 patients in the control group.The meta analysis results showed that compared with the control group,the total effective rate of the experimental group significantly improved[RR=1.30,95%CI(1.09,1.55),P=0.004],the LCQ score increased[WMD=2.97,95%CI(2.36,3.58),P<0.00001],the VAS score decreased[WMD=-1.63,95%CI(-3.16,-0.09),P<0.00001],and the cough symptom score decreased[WMD=-0.93,95%CI(-1.09,-0.77),P<0.00001].A total of 3 adverse reactions/events were reported,all of which were mild adverse reactions.Conclusion Compared with using conventional western medicine treatment alone,either using TCM external therapy alone or combining TCM external therapy with conventional western medicine to treat lung cancer-related cough can achieve better clinical efficacy,which can better improve the clinical symptoms of patient and the quality of patients’life with better safety.