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益气活血法治疗非小细胞肺癌的Meta分析
Meta analysis on the treatment of non-small cell lung cancer by invigorating qi and activating blood circulation
投稿时间:2019-04-23  修订日期:2019-06-20
DOI:
中文关键词:  非小细胞肺癌  益气活血法  随机对照试验  Meta分析
英文关键词:non-small cell lung cancer  Method of invigorating qi and activating blood circulation  Randomized controlled trial  Meta analysis
基金项目:(No:1808085QH256):基于基因干扰技术研究芪玉三龙汤抑制肺癌分子机制;负责人:张星星。,国家自然科学基金项目(面上项目,重点项目,重大项目)
作者单位E-mail
杨勤军 安徽中医药大学第一附属医院 1833500248@qq.com 
李泽庚 安徽中医药大学 li6609@126.com 
童佳兵 安徽中医药大学第一附属医院  
张星星 安徽中医药大学第一附属医院  
王心恒 安徽中医药大学  
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中文摘要:
      摘要:目的:非小细胞肺癌(NSCLC)的发病率逐年升高,中医药治疗NSCLC的临床研究也日益增多。本研究从近期有效率、KPS评分、免疫功能、凝血功能、骨髓抑制的发生对益气活血法治疗NSCLC进行客观评价。方法:计算机检索the Cochranne Library、PubMed、EMbase、中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)、维普数据库(VIP)、万方数据服务平台(Wanfang),2名研究者按照Cochrane评价标准单独筛选文献、提取资料,最终纳入10个研究,共340例NSCLC患者,运用软件RevMan5.3作Meta分析。结果:Meta分析结果显示:运用益气活血法治疗NSCLC,患者近期有效率[OR=1.87,95%CI=(1.36,2.58)]、KPS[OR=3.45,95%CI=(1.55,7.72)]的结果明显优于对照组;免疫功能指标CD3+[WMD=7.07,95%CI=(1.75,13.58)]、CD4+[WMD=9.30,95%CI=(5.71,12.89)]、CD4+/CD8+[WMD=0.54,95%CI=(0.28,0.62)]、NK[WMD=4.05,95%CI=(1.93,6.17)]较对照组明显提高,而CD8+[WMD=-3.30,95%CI=(-4.95,-1.65)]降低;凝血相关指标PT[WMD=3.41,95%CI=(3.04,3.77)]、APTT[WMD=2.26,95%CI=(0.09,4.43)]较对照组明显改善,FIB[WMD=-1.22,95%CI=(-2.55,-1.10)]无显著性差异;NSCLC患者化疗骨髓抑制的发生[OR=0.31,95%CI(0.14,0.68)]明显低于对照组。临床使用益气活血中药频数居前10位置的分别为黄芪、白术、白花蛇舌草、茯苓、半枝莲、人参、川芎、当归、莪术、三七。结论:目前证据显示临床治疗NSCLC时,应当注重中医益气活血法的应用,益气活血法配合化疗能够提高患者短期有效率,提高NSCLC患者免疫功能及改善血液高凝状态,改善患者生活质量。
英文摘要:
      Abstract: Objective: The incidence of non-small cell lung cancer (NSCLC) is increasing year by year, and clinical studies on the treatment of NSCLC with traditional Chinese medicine are also increasing. In this study, the short-term effective rate, KPS score, immune function index, coagulation index and the occurrence of bone marrow suppression were objectively evaluated for the treatment of NSCLC by invigorating qi and activating blood. Methods: PubMed, the Cochranne Library, CBM, EMbase, CNKI, Wanfang and VIP databases were searched by computer. The two researchers screened the literature and extracted the data separately according to the Cochrane evaluation criteria, and used the software RevMan5.3 for Meta analysis. A total of 340 NSCLC patients were eventually included in 10 studies. Results: A total of 340 NSCLC patients were included in 10 studies.Meta analysis results showed that the short-term effective rate [OR=1.90, 95%CI=(1.41,2.55))] and KPS[OR=3.45, 95%CI=(1.55,7.72)) of patients treated with NSCLC by invigorating qi and activating blood circulation method were significantly better than that of the control group.Immune index CD3+ (WMD=7.07,95%CI=(1.75,13.58)], CD4+ (WMD = 9.30, 95%CI=(5.71,12.89)], CD4+/CD8+ (WMD=0.54, 95% CI=(0.28, 0.62)], NK (WMD=4.05,95%CI=(1.93,6.17)] was improved obviously, and CD8+ (WMD=3.30,95%CI=(4.95,1.65)];Related parameters of blood coagulation PT(WMD=3.41,95%CI=(3.04,3.77)], PTT (WMD=2.26, 95% CI = (0.09, 4.43)] was obviously improved, FIB (WMD=1.22,95% CI=(2.55,1.10)] there was no significant difference; The incidence of chemotherapeutic bone marrow suppression in NSCLC patients [OR=0.31,95%CI(0.14,0.68)] was significantly lower than that in the control group. The ten most frequently used TCM in clinic were Huangqi, Baizhu, Baihuasheshecao, Fuling, Banzhilian, Renshen, Chuanxiong, Danggui, Ezhu and Sanqi, respectively.Current evidence suggests that in clinical treatment of NSCLC, attention should be paid to the application of TCM invigorating qi and activating blood circulation method. Conclusion: Adjuvant chemotherapy can improve short-term effective rate, quality of life, immunity and hypercoagulation of NSCLC patients.
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