沙参麦冬汤加减联合化疗治疗非小细胞肺癌的Meta分析

目的:系统评价沙参麦冬汤加减联合化疗治疗非小细胞肺癌的有效性和安全性。方法:利用计算机检索CNKI,Wanfang Data,VIP,CBM及Pub Med,查找各数据库建库日起至2015年有关沙参麦冬汤加减联合化疗与单纯化疗治疗非小细胞肺癌的临床随机对照研究。按照纳入/排除标准筛选文献,对纳入研究进行质量评价和数据提取,然后采用Revmen 5.3软件进行Meta分析。结果:10个临床随机对照试验纳入系统评价,均是Jadad评分小于3的低质量研究。Meta结果显示:与对照组相比,沙参麦冬汤加减联合化疗治疗非小细胞肺癌的有效率OR=1.70,95%CI(1.25,2.31),P=0.000 7]和稳定率OR=2.26,95%CI(1.51,3.37),P0.000 1]更高,减少骨髓抑制OR=0.42,95%CI(0.23,0.78),P=0.006],其差异具有统计学意义。在降低肝功能OR=0.67,95%CI(0.38,1.20),P=0.18],肾功能损害OR=0.77,95%CI(0.38,1.57),P=0.48]及胃肠道症状OR=0.61,95%CI(0.34,1.12),P=0.11]方面与对照组相比无显著差异。结论:沙参麦冬汤加减联合化疗治疗非小细胞肺癌具有较好的疗效,降低骨髓抑制的化疗毒副反应。但现有的研究证据级别较低,还要更多大样本、高质量、多中心的临床随机对照试验进一步验证。

Meta-analysis of Modified Shashen Maidong Tang Combined with Chemotherapy in Treating Patients with Non-small Cell Lung Cancer

Objective: To systemically evaluate the efficacy and the safety of modified Shashen Maidong Tang combined with chemotherapy in treating patients with non-small cell lung cancer. Method: We searched randomized controlled clinical studies on modified Shashen Maidong Tang combined with chemotherapy for non-small cell lung cancer in the databases of CNKI, Wanfang Data, VIP, CBM and PubMed from the database building date to 2015.Articles were selected in accordance with the inclusion/exclusion criteria;quality of included studies was evaluated and data was extracted, then Revmen5.3 software was used for Meta-analysis. Result: The 10 randomized controlled trials were included for systematic review, all of which were of low quality studies with Jadad score<3.Meta results showed that:compared with the control group, the effective rate OR= 1.70, 95%CI (1.25, 2.31), P=0.000 7] and stable rate OR=2.26, 95%CI (1.51, 3.37), P<0.000 1] of Shashen Maidong Tang combined with chemotherapy for non-small cell lung were higher, and it could reduce bone marrow suppression OR=0.42, 95%CI (0.23, 0.78), P=0.006], with statistically significant difference. In respect of reducing liver function OR=0.67, 95%CI (0.38, 1.20), P=0.18], renal impairment OR=0.77, 95%CI (0.38, 1.57), P=0.48] and gastrointestinal symptoms OR=0.61, 95%CI (0.34, 1.12), P=0.11], there was no significant difference between Shashen Maidong Tang combined with chemotherapy group and control group. Conclusion: Shashen Maidong Tang combined with chemotherapy for non-small cell lung cancer have better efficacy and could reduce side effects of chemotherapy such as marrow suppression. However, the existing research evidence level is low, and more large-sample, high-quality, and multi-center randomized controlled trials are still needed for further verification.