Efficacy and safety of Kang’ai injection adjunct with TP chemotherapy for the treatment of non-small cell lung cancer: a systematic review and meta-analysis of randomized controlled trials

Background:Combination therapy with traditional Chinese medicine and chemotherapy was proposed as a therapeutic strategy for non-small cell lung cancer patients.Therefore,we performed a systematic review and metaanalysis of randomized controlled trials to assess effects of this combination therapy on non-small cell lung cancer.To evaluate the efficacy and safety of the Chinese patent medicine Kang’ai injection adjunct with TP chemotherapy in the treatment of non-small cell lung cancer.Methods:A randomized controlled study of the Chinese patent medicine Kang’ai injection adjunct with TP chemotherapy in the databases of China National Knowledge Infrastructure Database,WanFang Database,VIP Database,Sino-Med Database,PUBMED,EMBASE and Cochrane library was searched by computer.The literatures published from the database establishment to July 1,2020 were included in the search scope.After 2 evaluators independently evaluated and cross checked the quality of the study,Revman 5.3 was used to meta analyze the clinical effect of the Chinese patent medicine Kang’ai injection adjunct with TP chemotherapy on patients with non-small cell lung cancer.Results:A total of 1,370 lung cancer patients were included in 20 RCTs.The results of meta-analysis showed that there were significant differences between the 2 groups in clinical efficacy(RR=1.32,95%CI(1.20,1.44)),quality of life(RR=1.44,95%CI(1.32,1.57)),immune function(MD=0.53,95%CI(0.23–0.83)),adverse reactions(RR=0.49,95%CI(0.41,0.58)).Conclusion:The Chinese patent medicine Kang’ai injection adjunct with TP chemotherapy is effective and safe in the treatment of non-small cell lung cancer,and has great prospects for further development.However,the quality of evidence was very low-to-moderate.Considering the poor quality of evidence,we are not very confident in the results.We look forward to more research and update results in the future and improve the evidence quality.

Acupuncture and related therapies used as add-on to conventional treatments for heart failure:A systematic review of pairwise and network meta-analyses

Objective: This study aimed to assess and compare the clinical efficacy and safety of acupuncture and related therapies(ARTs) add-on to conventional treatment(CT) for heart failure(HF) through pairwise and network meta-analyses.Methods: Six electronic databases, including PubMed, the Cochrane Central Register of Controlled Trials(CENTRAL), EMBASE, Chinese Biomedical Literature Database(CBM), China National Knowledge Infrastructure(CNKI) and Wanfang Database were searched from inceptions to December 2017. Randomized controlled trials(RCTs) regarding ARTs combining with CT for HF were eligible. The primary outcomes were changes in heart function classification(HFC) according to New York Heart Association class and left ventricular ejection fraction(LVEF). Risk of bias assessment was conducted by two independent authors.Pairwise and network meta-analyses were performed using STATA 13.0 and WinBUGS 1.4.3 software.Results: A total of 26 RCTs were enrolled for analyses, with 5 kinds of ARTs and 2116 patients in all. Pairwise meta-analyses showed that acupoint application(OR: 3.28, 95%CI[2.26, 4.76]), acupuncture(OR: 2.78, 95%CI[1.21, 6.41]), acupoint injection(OR: 3.33, 95%CI[1.85, 6.00]) and moxibustion(OR: 2.51,95%CI[1.02, 6.21]) could significantly improve HFC when they were used as add-on to CT. Acupoint application(MD: 3.57, 95%CI[ 1.45, 5.70]),acupuncture(MD: 7.75, 95%CI[2.33. 13.17]). acupoint injection(MD:4.81, 95%CI[2.99, 6.63]) and moxibustion(MD: 6.99, 95%CI[3.62, 10.36]) were significantly beneficial in improving LVEF. Network meta-analyses showed that acupoint injection(SUCRA = 70.0%) and acupuncture(SUCRA = 90.4%) respectively had the greatest probability in improving HFC and LVEF.Conclusion: Most of the included ARTs add-on to CT was effective in improving HFC and LVEF. Acupoint injection and acupuncture may respectively have better effect than others for HFC and LVEF. However,due to the small sample size and poor quality of the included studies, hence well-designed RCTs are needed to confirm our findings.This study was registered in PROSPERO, CRD42018087700.