黄芪注射液辅助放化疗对癌症患者疗效和不良反应的系统评价

目的 系统评价黄芪注射液联合放化疗对癌症患者疗效和免疫功能的影响，为临床使用提供循证医学的相关参考。方法 计算机检索中国期刊全文数据库（CNKI）、万方数据库（Wanfang Deta）、中国生物医学文献数据库（CBM）、维普生物医学数据库（VIP）、PubMed、Cochrane图书馆等数据库中有关黄芪注射液联合放化疗治疗癌症的随机对照临床试验（RCT），检索时间为各数据库建库起至2021年11月1日。使用Cochrane工具评价文献质量，用RevMan 5.3软件进行Meta分析。结果 共纳入16项RCTs，1 340例患者。Meta分析结果显示：黄芪注射液在辅助癌症的放化疗治疗中能显著提高治疗有效率［RR=1.96，95% CI（1.53，2.50）］，提高患者CD₃⁺［MD=7.47，95% CI（5.05，9.90）］、CD₄⁺［MD=4.96，95% CI （3.84，6.09） ］、CD₈⁺ ［MD=7.47，95% CI （5.05，9.90） ］水平、CD₄⁺/CD₈⁺的值［MD=0.29，95% CI （0.20，0.14）］，有效改善患者生存质量［RR=11.48，95% CI=（10.44，12.51）］，改善放化疗引起的口干、黏膜损伤、皮炎损伤等不良反应发生率，与对照组比较差异均具有显著意义（P＜0.000 01）。结论 黄芪注射液协同放化疗治疗癌症可以提高治疗有效率、改善患者生活质量、促进患者免疫功能、降低不良反应，鉴于研究局限性，尚需更多高质量、大样本RCTs进一步验证。

Meta-analysis of effects of Astragalus Injection combined with chemoradiotherapy on efficacy and immune function of cancer patients

Objective To systematically evaluate the effects of Astragalus Injection combined with radiotherapy and chemotherapy on the efficacy and immune function of cancer patients, and to provide evidence-based medicine reference for clinical use. Methods Data were electronically searched from CNKI, Wanfang Deta, CBM, VIP, PubMed, Cochrane Library to collet randomized controlled trails (RCTs) on Astragalus Injection combined with radiotherapy and chemotherapy in the treatment of cancer from the establishment of each database to November 1, 2021. Cochrane tools were used to evaluate the literature quality and RevMan 5.3 software was used for Meta-analysis. Results A total of 16 RCTs involving 1 340 patients were included. Meta-analysis showed that the use of Astragalus Injection in adjuvant chemoradiotherapy for cancer significantly increased the effective rate [RR = 1.96, 95%CI (1.53, 2.50)], and increased CD₃⁺[MD = 7.47, 95%CI (5.05, 9.90)], CD₄⁺ [MD = 4.96, 95%CI (3.84, 6.09)], CD₈⁺ [MD = 7.47,95%CI (5.05, 9.90)], CD₄⁺/CD₈⁺ [MD = 0.29, 95%CI (0.20, 0.14)], can effectively improve the quality of life [RR = 11.48, 95%CI (10.44, 12.51)], and has significant significance compared with the control group (P<0.000 01). It can improve the incidence of dry mouth, mucous membrane injury, dermatitis injury and other toxic and side effects caused by radiotherapy and chemotherapy, and has significant significance compared with the control group (P<0.000 01). Conclusion Astragalus Injection combined with radiotherapy and chemotherapy in the treatment of cancer can improve the effective rate of treatment, improve the quality of life of patients, promote the immune function of patients, and reduce adverse reactions. In view of the limitations of the study, more highquality, large-sample RCTs are needed for further verification.