中医扶正解毒法治疗晚期非小细胞肺癌的Meta分析
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篇名: 中医扶正解毒法治疗晚期非小细胞肺癌的Meta分析
TITLE: Meta-analysis of Fuzheng jiedu therapy of traditional Chinese medicine in the treatment of advanced non-small cell lung cancer
摘要: 目的 系统评价中医扶正解毒法对晚期非小细胞肺癌的治疗效果。方法计算机检索PubMed、中国生物医学文献数据库、中国期刊全文数据库、维普数据库和万方数据服务平台,检索时限为数据库建库起至2023年10月,收集中医扶正解毒法+常规化疗(试验组)对比常规化疗(对照组)治疗非小细胞肺癌的随机对照试验。2名研究人员分别筛选文献、提取资料,按照Cochrane5.4偏倚风险工具评价文献质量,并使用RevMan5.3软件对数据进行Meta分析。结果本研究最终纳入19篇文献。Meta分析结果显示,试验组患者的疾病控制率[RR=1.15,95%CI(1.07,1.23),P=0.0001]、客观缓解率[RR=1.47,95%CI(1.29,1.67),P<0.00001]、卡氏评分[WMD=6.11,95%CI(2.97,9.25),P=0.0001]、免疫功能指标(CD3+、CD4+、CD4+/CD8+)水平、炎症因子指标[白细胞介素2(IL-2)、干扰素γ(IFN-γ)]水平、肺功能指标(用力肺活量、第1秒用力呼气容积、最大呼气流量)均高于对照组(P<0.05)。试验组患者的证候情况评分[WMD=-2.83,95%CI(-4.42,-1.24),P=0.0005]、IL-6[WMD=-11.20,95%CI(-21.75,-0.64),P=0.04]水平、不良反应(骨髓抑制、肝肾损伤、胃肠反应)发生率均低于对照组(P<0.05)。此外,试验组患者的自然杀伤细胞水平虽高于对照组,但差异无统计学意义(P>0.05)。结论与单纯常规化疗相比,中医扶正解毒法联合常规化疗在提高晚期非小细胞肺癌患者疾病控制率和客观缓解率、提高生活质量、改善中医证候和炎症状态、增强免疫力和肺部功能、降低不良反应发生率等方面具有明显优势。
ABSTRACT: OBJECTIVE To evaluate the therapeutic effects of Fuzheng jiedu therapy of traditional Chinese medicine (TCM) in the treatment of advanced non-small cell lung cancer (NSCLC). METHODS Randomized controlled trials on the treatment of NSCLC with Fuzheng jiedu therapy of TCM+conventional chemotherapy (trial group) versus conventional chemotherapy (control group) were collected by searching PubMed, CBM, China Periodicals Full Text Database, VIP and Wanfang data service platform during the inception-Oct.Two researchers respectively screened the literature and extracted data, evaluated the quality according to Cochrane 5.4 tool, and used RevMan 5.3 software to perform meta-analysis on the data. RESULTS Nineteen pieces of literature were finally included in the study; meta-analysis showed disease control rate [RR=1.15, 95%CI (1.07, 1.23), P= 0.000 1], objective remission rate [RR=1.47, 95%CI (1.29, 1.67), P<0.000 01], Karnofsky performance scores [WMD=6.11, 95%CI (2.97, 9.25), P=0.000 1], the levels of immune function indexes (CD3+, CD4+, CD4+/CD8+), inflammatory factor indicators [interleukin-2 (IL-2), interferon-γ (IFN-γ)] and lung function indexes (forced vital capacity, forced expiratory volume in the first second and peak expiratory flow) in the trial group were higher than control group (P<0.05). The symptomatic score [WMD=-2.83, 95%CI (-4.42, -1.24), P=0.000 5], the levels of IL-6 [WMD=-11.20, 95%CI (-21.75,-0.64), P= 0.04], and the incidence of ADRs (myelosuppression, hepatic and renal injury, gastrointestinal reactions in trial group were all lower than control group (P<0.05). In addition, the levels of natural killer cells in the trial group were higher than the control group, but the results were not statistically significant (P>0.05). CONCLUSIONS Compared with conventional chemotherapy, Fuzheng jiedu therapy of TCM combined with conventional chemotherapy has obvious advantages in increasing the disease control rate and objective remission rate, improving the quality of life, promoting TCM syndrome and inflammatory status,enhancing immunity and lung function, and decreasing the incidence of ADRs in NSCLC patients.
期刊: 2024年第35卷第13期
作者: 李卓;乔玲;王艺洁;王维
AUTHORS: LI Zhuo,QIAO Ling,WANG Yijie,WANG Wei
关键字: 扶正解毒法;晚期非小细胞肺癌;中医药;Meta分析
KEYWORDS: Fuzheng jiedu therapy; advanced non-small
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