补中益气汤加减联合铂类化疗对中晚期非小细胞肺癌疗效及不良反应的Meta分析  

Meta-analysis of Efficacy and Side Effects of Buzhong Yiqi Decoction(补中益气汤) Combined with Platinum Chemotherapy for Advanced Non-Small Cell Lung Cancer

作　　者：邱汉波 周尧红 赵艺蔓 张颖 郑景辉[1] 侯恩存[1] QIU Hanbo;ZHOU Yaohong;ZHAO Yiman;ZHANG Yin;ZHENG Jinghui;HOU Encun(Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine Nanning 530011,Guangxi,China)

机构地区：[1]广西中医药大学附属瑞康医院,广西南宁530011

出　　处：《实用中医内科杂志》2021年第11期32-36,I0009-I0012,共9页Journal of Practical Traditional Chinese Internal Medicine

基　　金：国家自然科学基金项目(81660766);广西一流学科建设资助专项(桂财教函[2019]49)。

摘　　要：目的系统评价补中益气汤加减联合铂类化疗对中晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的疗效及不良反应。方法计算机检索PubMed、Embase、The Cochrane Library、中国知网、万方医学期刊、维普中文期刊、中国生物医学文献数据库,检索有关补中益气汤加减联合铂类化疗(试验组)对比单纯铂类化疗(对照组)治疗中晚期NSCLC的随机对照研究。检索时限均为从建库至2020年06月30日。通过筛选,提取数据及对纳入研究进行质量评价后,采用Stata 14软件进行Meta分析,计算危险比(risk ratio,RR)及其95%可信区间(confidence interval,CI)。结果纳入19项RCTs,共1412例中晚期NSCLC患者。Meta分析结果显示:试验组可提高患者客观缓解率(objective response rate,ORR)(RR=1.21,95%CI:1.11,1.33,P=0.002);改善中医证候积分(SMD=-4.68,95%CI:-6.70,-2.67,P=0.000);提高生活质量(RR=1.71,95%CI:1.22,2.38,P=0.002);减少恶心呕吐(RR=0.54,95%CI:0.44,0.66,P=0.000)、头晕(RR=0.39,95%CI:0.21,0.75,P=0.005)、胃肠不适(RR=0.71,95%CI:0.59,0.85,P=0.000)等症状的发生;减轻白细胞降低(RR=0.68,95%CI:0.60,0.78,P<0.05)、血红蛋白降低(RR=0.61,95%CI:0.45,0.84,P=0.002)、肝功能损伤(RR=0.51,95%CI:0.35,0.75,P=0.001)、肾功能损伤(RR=0.50,95%CI:0.32,0.80,P=0.004)等不良反应。咳嗽(RR=0.34,95%CI:0.10,1.14,P=0.082)发生风险组间无明显差异。结论补中益气汤加减联合铂类化疗可提高患者临床疗效,提高生活质量,改善临床症状,减轻白细胞降低、白细胞降低。Objective To systematically evaluate the efficacy and adverse reactions of Buzhong Yiqi Decoction(补中益气汤)combined with platinum chemotherapy for advanced non-small cell lung cancer(NSCLC).Methods Computer search was performed on PubMed,Embase,the Cochrane Library,CNKI,Wanfang Medical Journal,Weipu Chinese journaland Chinese biomedical literature database to retrieve randomized controlled studies on the treatment of advanced NSCLC with Buzhong Yiqi Decoction combined with platinum chemotherapy(experimental group)versus platinum chemotherapy alone(control group).The retrieval time was from the date of database construction to June 31,2020.After screening,the data was extracted and the quality of included studies were evaluated.Stata 14 software was used for Meta-analysis and risk ratio(RR)and 95%confidence interval(CI)were calculated.Results A total of 1412 patients with advanced NSCLC were included in 19 RCTs.Meta-analysis results showed that the experimental group could improve the objective response rate(ORR)(RR=1.21,95%CI:1.11,1.33,P=0.002),TCM syndrome score(SMD=-4.68,95%CI:-6.70,-2.67,P=0.000)and quality of life(RR=1.71,95%CI:1.22,2.38,P=0.002),reduce the incidence of nausea and vomiting(RR=0.54,95%CI:0.44,0.66,P=0.000),dizziness(RR=0.39,95%CI:0.21,0.75,P=0.005)and gastrointestinal discomfort(RR=0.71,95%CI:0.59,0.85,P=0.000).The adverse reactions including decreased white blood cells(RR=0.68,95%CI:0.60,0.78,P<0.05),decreased hemoglobin(RR=0.61,95%CI:0.45,0.84,P=0.002),liver function injury(RR=0.51,95%CI:0.35,0.75,P=0.001),renal function injury(RR=0.50,95%CI:0.32,0.80,P=0.004)were alleviated.The incidence of cough(RR=0.34,95%CI:0.10,1.14,P=0.082)showed no significant difference between the two groups.Conclusion The combination of Buzhong Yiqi Decoction and platinum-based chemotherapy can improve the clinical efficacy,the quality of life and the clinical symptoms,and reduce the decrease of white blood cells.

关 键 词：补中益气汤 沙参麦冬汤 非小细胞肺癌 化疗 META分析 

分 类 号：R734.2[医药卫生—肿瘤]