浏览全部资源
扫码关注微信
重庆大学附属肿瘤医院中医肿瘤治疗中心,重庆 400030
Published:15 July 2024,
Received:07 December 2023,
Revised:29 April 2024,
扫 描 看 全 文
李卓,乔玲,王艺洁等.中医扶正解毒法治疗晚期非小细胞肺癌的Meta分析 Δ[J].中国药房,2024,35(13):1651-1657.
LI Zhuo,QIAO Ling,WANG Yijie,et al.Meta-analysis of Fuzheng jiedu therapy of traditional Chinese medicine in the treatment of advanced non-small cell lung cancer[J].ZHONGGUO YAOFANG,2024,35(13):1651-1657.
李卓,乔玲,王艺洁等.中医扶正解毒法治疗晚期非小细胞肺癌的Meta分析 Δ[J].中国药房,2024,35(13):1651-1657. DOI: 10.6039/j.issn.1001-0408.2024.13.18.
LI Zhuo,QIAO Ling,WANG Yijie,et al.Meta-analysis of Fuzheng jiedu therapy of traditional Chinese medicine in the treatment of advanced non-small cell lung cancer[J].ZHONGGUO YAOFANG,2024,35(13):1651-1657. DOI: 10.6039/j.issn.1001-0408.2024.13.18.
目的
2
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
2
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Cochrane 5.4偏倚风险工具评价文献质量,并使用RevMan 5.3软件对数据进行Meta分析。
结果
2
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
=0.000 1
]
、客观缓解率[RR=1.47,95%CI(1.29,1.67),
P
<0.000 01
]
、卡氏评分[WMD=6.11,95%CI(2.97,9.25),
P
=0.000 1
]
、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
=0.000 5
]
、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
2
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。
OBJECTIVE
2
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
2
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. 2023. 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
2
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
2
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.
扶正解毒法晚期非小细胞肺癌中医药Meta分析
advanced non-small cell lung cancertraditional Chinese medicinemeta-analysis
SUNG H,FERLAY J,SIEGEL R L,et al. Global cancer statistics 2020:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin,2021,71(3):209-249.
SCHABATH M B,COTE M L. Cancer progress and prio- rities:lung cancer[J]. Cancer Epidemiol Biomarkers Prev,2019,28(10):1563-1579.
王笑民,郁仁存,王禹堂,等. 晚期非小细胞肺癌患者气虚血瘀证的研究[J]. 中国中西医结合杂志,1994,14(12):724-726.
WANG X M,YU R C,WANG Y T,et al. Study on advanced non-small cell lung cancer patients with qi deficiency and blood stasis syndrome[J]. Chin J Integr Tradit West Med,1994,14(12):724-726.
丁惠卿,赵莹,吕克,等. 扶正解毒汤对晚期非小细胞肺癌患者肺功能改善的效果观察[J]. 河北中医,2016,2(11):1656-1659.
DING H Q,ZHAO Y,LYU K,et al. Effect of Fuzheng jiedu decoction on improving lung function in patients with advanced non-small cell lung cancer[J]. Hebei J Tradit Chin Med,2016,2(11):1656-1659.
叶明,高坤. 扶正解毒方联合化疗治疗肺癌临床研究[J]. 河南中医,2016,36(1):107-109.
YE M,GAO K. Clinical study on healthy qi-strengthening and toxin-eliminating formula combined with chemotherapy on lung cancer[J]. Henan Tradit Chin Med,2016,36(1):107-109.
孙龙华,章淑芳,罗来恒,等. 解毒扶正散对非小细胞肺癌免疫微环境的影响[J]. 实用临床医学,2017,18(10):1-3,15.
SUN L H,ZHANG S F,LUO L H,et al. Effect of Jiedu fuzheng san on tumor immune microenvironment of non-small cell lung cancer[J]. Pract Clin Med,2017,18(10):1-3,15.
宋庆,张春盈,冯艳亮. 晚期非小细胞肺癌化疗期经扶正解毒汤治疗的疗效及对肺功能、免疫功能的影响[J]. 淮海医药,2019,5(6):636-639.
SONG Q,ZHANG C Y,FENG Y L. Therapeutic effect of Fuzheng jiedu decoction on advanced non-small cell lung cancer during chemotherapy and its influence on lung function and immune function[J]. J Huaihai Med,2019,5(6):636-639.
张富亮,孔凡铭,李冬生,等. “固本解毒祛瘀” 方药联合化疗治疗晚期非小细胞肺癌疗效观察[J]. 天津中医药,2017,34(5):320-322.
ZHANG F L,KONG F M,LI D S,et al. Effect of Guben jiedu quyu prescription with chemotherapy on the NSCLC[J]. Tianjin J Tradit Chin Med,2017,34(5):320-322.
张璇,陈茜,魏科祥,等. 扶正解毒方联合恩度对晚期非小细胞肺癌患者肺功能、T细胞亚群和生存质量的影响[J]. 现代生物医学进展,2021,21(20):3974-3978.
ZHANG X,CHEN X,WEI K X,et al. The effect of Fuzheng jiedu formula combined with Endu on lung function,T cell subsets and quality of life in patients with advanced non-small cell lung cancer[J]. Prog Mod Biomed,2021,21(20):3974-3978.
曹建雄,伍群业. 扶正解毒汤对晚期肺癌化疗患者免疫功能影响的临床观察[J]. 中国中医药科技,2005(3):184.
CAO J X,WU Q Y. Clinical observation on the effect of Fuzheng jiedu decoction on immune function of patients with advanced lung cancer undergoing chemotherapy[J]. Chin J Tradit Med Sci Technol,2005(3):184.
李自强,许贺娟,郭雨浩. 扶正解毒汤联合GP方案治疗老年肺癌临床观察[J]. 山西中医,2021,37(9):23-24.
LI Z Q,XU H J,GUO Y J. Clinical efficacy observation of Fuzheng jiedu decoction and GP schemes on senile lung cancer[J]. Shanxi J Tradit Chin Med,2021,37(9):23-24.
杨丽琴,田菲. 健脾祛瘀解毒法联合化疗治疗脾虚毒瘀型非小细胞肺癌疗效观察[J]. 四川中医,2015,1(4):72-74.
YANG L Q,TIAN F. Clinical observation on streng- thening spleen,removing blood stasis and detoxicating combined with chemotherapy in the treatment of non-small cell lung cancer with spleen deficiency and toxic blood stasis[J]. J Sichuan Tradit Chin Med,2015,1(4):72-74.
王伟,金朝晖,范伏元,等. 扶正解毒方联合吉西他滨和顺铂对晚期非小细胞肺癌患者T细胞亚群和血清肿瘤标志物的影响[J]. 现代生物医学进展,2021,21(4):710-713.
WANG W,JIN Z H,FAN F Y,et al. Effect of Fuzheng jiedu formula combined with gemcitabine and cisplatin on T cell subsets and serum tumor markers in patients with advanced non-small cell lung cancer[J]. Prog Mod Biomed,2021,21(4):710-713.
王羽超,许斌,李丽,等. 扶正解毒抗癌方对晚期非小细胞肺癌肺脾两虚型患者疗效及化疗后骨髓抑制的影响[J]. 肿瘤药学,2021,11(1):82-86.
WANG Y C,XU B,LI L,et al. Effects of Fuzheng jiedu anti-cancer prescription on the efficacy and bone marrow suppression of advanced non-small cell lung cancer patients with pulmonary and splenic deficiency[J]. Anti Tumor Pharm,2021,11(1):82-86.
程晓玉,贾英杰,李小江,等. 扶正解毒祛瘀方联合化疗治疗非小细胞肺癌30例临床观察[J]. 湖南中医杂志,2015,31(9):3-5.
CHENG X Y,JIA Y J,LI X J,et al. Efficacy of Fuzheng jiedu quyu prescription combined with chemotherapy for treating non-small cell lung cancer:a clinical study of 30 patients[J]. Hunan J Tradit Chin Med,2015,31(9):3-5.
章迅,叶丽红,彭海燕,等. 补虚化毒方联合化疗治疗晚期非小细胞肺癌临床研究[J]. 辽宁中医药大学学报,2010,12(9):23-24.
ZHANG X,YE L H,PENG H Y,et al. Clinical investigation of treating advanced non-small cell lung cancer(NSCLC) by tonifying deficiency and resolving toxin prescription combined with chemotherapy[J]. J Liaoning Univ Tradit Chin Med,2010,12(9):23-24.
罗俊波,文海英. 扶正解毒汤联合化疗治疗非小细胞肺癌的有效性研究[J]. 中国药物滥用防治杂志,2021,27(3):414-416,426.
LUO J B,WEN H Y. Effect of Fuzheng jiedu decoction on immune function of patients with non-small cell lung cancer chemotherapy[J]. Chin J Drug Abuse Prev Treat,2021,27(3):414-416,426.
胡述博,端木泮泮,赵明燕. 紫杉醇、顺铂联合扶正解毒汤对晚期肺癌患者免疫功能及炎症因子水平的影响[J]. 癌症进展,2020,18(21):2205-2208.
HU S B,DUANMU P P,ZHAO M Y. Effects of paclitaxel and cisplatin combined with Fuzheng jiedu decoction on immune function and inflammatory factor levels in patients with advanced lung cancer[J]. Oncol Prog,2020,18(21):2205-2208.
舒君,陆兵,吕红,等. 扶正解毒抗癌方结合GP方案对晚期NSCLC患者疗效、骨髓抑制发生率及Pokemon、TK1水平的影响[J]. 四川中医,2020,38(12):79-83.
SHU J,LU B,LYU H,et al. Effects of Fuzheng jiedu kangai recipe combined with GP regimen on the efficacy,bone marrow suppression incidence and Pokemon and TK1 levels in patients with advanced NSCLC[J]. J Sichuan Tradit Chin Med,2020,38(12):79-83.
陆兵,吕红,余静,等. 扶正解毒汤联合鸦胆子油乳注射液对晚期非小细胞肺癌患者免疫功能、肺功能以及血脂的影响[J]. 世界中医药,2020,15(9):1317-1321.
LU B,LYU H,YU J,et al. Effects of Fuzheng jiedu decoction combined with Brucea javanica oil emulsion injection on advanced non-small cell lung cancer[J]. World Chin Med,2020,15(9):1317-1321.
马红兵,奚颖. 沙参麦冬汤合五味消毒饮治疗阴虚毒热证老年中晚期肺癌患者的效果[J]. 临床医学研究与实践,2021,6(16):153-155.
MA H B,XI Y. Effect of Shashen maidong decoction combined with five-ingredient toxin-dispersing beverage on elderly patients with middle and advanced lung cancer of Yin deficiency toxin heat syndrome[J]. Clin Res Pract,2021,6(16):153-155.
黄开红,王亚军,练剑锋,等. 扶正解毒汤联合督脉灸对肺脾气虚证晚期非小细胞肺癌患者的治疗效果及对免疫炎症水平的影响[J]. 中国医药导报,2023,20(22):128-131.
HUANG K H,WANG Y J,LIAN J F,et al. Effect of Fuzheng jiedu decoction and dumai moxibustion in the treatment of non small cell lung cancer patients in the late stage of lung and spleen deficiency syndrome and the level of immune inflammation[J]. China Med Her,2023,20(22):128-131.
谢红霞,孔凡铭,樊一桦,等. 贾英杰从正虚毒瘀论治肺癌方药挖掘[J]. 中医肿瘤学杂志,2021,3(2):62-67.
XIE H X,KONG F M,FAN Y H,et al. Data mining of medication rules for treating lung cancer by professor JIA Yingjie based on pathogenesis of healthy qi deficiency with toxin and blood stasis[J]. J Oncol Chin Med,2021,3(2):62-67.
卓桂锋,沈双宏,陈逸梦,等. 杜建教授应用芪灵扶正清解方治疗肺癌术后临床经验[J]. 福建中医药,2021,7(3):38-39.
ZHUO G F,SHEN S H,CHEN Y M,et al. Professor Du Jian’s clinical experience in the treatment of postoperative lung cancer using Qiling fuzheng qingjie recipe[J]. Fujian J Tradit Chin Med,2021,7(3):38-39.
郭刚,李恒,郭琦,等. 吉非替尼对非小细胞肺癌患者免疫功能的影响[J]. 中国临床药理学杂志,2016,32(6):505-507.
GUO G,LI H,GUO Q,et al. Influence of gefitinib on immune function in non-small cell lung cancer patients[J]. Chin J Clin Pharmacol,2016,32(6):505-507.
王丽娜,赵继福. 自拟扶正抗癌汤对晚期非小细胞肺癌患者(气阴两虚型)外周血T淋巴细胞亚群的影响[J]. 现代医学与健康研究电子杂志,2023,9(12):19-21.
WANG L N,ZHAO J F. Effect of Fuzheng kangai decoction on T lymphocyte subsets in peripheral blood of patients with advanced non-small cell lung cancer (deficiency of both Qi and Yin)[J]. Mod Med Health Res Electron J,2023,9(12):19-21.
刘丽荣,刘译鸿,张海波. 肿瘤炎性微环境及其对肿瘤相关巨噬细胞抑制的研究进展[J]. 疑难病杂志,2020,19(2):193-197.
LIU L R,LIU Y H,ZHANG H B. Research progress on tumor inflammatory microenvironment and its inhibition on tumor-associated macrophages[J]. Chin J Difficult Complicat Cases,2020,19(2):193-197.
冯蓓,冯艳,师晓艳. 顺铂同步放疗联合扶正祛邪中药治疗中晚期宫颈癌的研究[J]. 现代中西医结合杂志,2019,5(20):2247-2249,2253.
FENG B,FENG Y,SHI X Y. Study on the treatment of intermediate and advanced cervical cancer with cisplatin concurrent radiotherapy combined with traditional Chinese medicine to strengthen the body and eliminate evil[J]. Mod J Integr Tradit Chin West Med,2019,5(20):2247-2249,2253.
沈丽萍,刘苓霜,姜怡,等. 扶正解毒法联合盐酸埃克替尼治疗老年晚期肺腺癌的临床研究[J]. 天津中医药大学学报,2019,38(5):445-451.
SHEN L P,LIU L S,JIANG Y,et al. Clinical study on the treatment of elderly lung adenocarcinoma with Chinese medicine combined with icotinib[J]. J Tianjin Univ Tradit Chin Med,2019,38(5):445-451.
0
Views
0
下载量
0
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution