益气除痰法联合化疗对晚期非小细胞肺癌患者生存质量的Meta分析
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摘要
目的系统评价益气除痰法联合化疗对晚期非小细胞肺癌患者生存质量的影响。方法计算机检索中国生物医学文献数据库、CNKI、VIP、万方、pubmed、Embase、The cochrane library等数据库,收集益气除痰法联合化疗与单用化疗比较对III-IV期非小细胞肺癌患者生存质量影响的随机对照试验。经过文献筛选和评价质量后提取有效数据使用Revman5.3进行Meta分析。结果共检索到符合纳入标准的中文文献10篇604例患者。Meta分析:观察组的近期客观疗效[OR=1.78,95%CI(1.23,2.57),P<0.00001]、生存质量评分[OR=3.08,95%CI(2.02,4.71),P<0.00001]、乏力改善程度[OR=0.15,95%CI(0.06,0.38),P<0.00001]均显著高于对照组,差异具有统计学意义;疼痛缓解度[OR=1.47,95%CI(0.87,2.48),P=0.15]两组没有明显差异。结论益气除痰法联合化疗可显著提升晚期非小细胞肺癌的客观疗效并改善患者的生存质量。受纳入研究样本量和研究方法质量限制,上述结论尚待开展更多高质量的循证医学研究予以证实。
Objective To have systematic reviews about TCM therapy( Invigorating Qi and Expelling Phlegm) combined with chemotherapy on quality of life of patients with non-small-cell lung cancer( NSCLC) at stages Ⅲ-Ⅳ. Methods Such databases as Pub Med,the cochrane library,CNKI,VIP,EM base,Wan Fang and CBM were electronically searched to collect the randomized controlled trials( RCT) about TCM therapy combined with chemotherapy compared with single chemotherapy. We appraised the quality of the data and used Rev Man 5. 3 to get the Meta-analysis. Results Totally10 RCTs involving 604 cases were included. The results of meta-analysis showed that the TCM therapy combined with chemotherapy can significantly improve the effective rate[OR = 1. 78,95% CI( 1. 23,2. 57),P < 0. 00001],improvementrate of life quality[OR = 3. 08,95% CI( 2. 02,4.71),P < 0. 00001]and improvement of fatigue reliving rate[OR = 0. 15,95% CI( 0. 06,0. 38),P < 0. 00001],the differences had statistical significance. And there was no significant difference in the improvement of chest pain reliving rate[OR = 1. 47,95% CI( 0. 87,2. 48),P = 0. 15]. Conclusion Compared with the pure chemotherapy,the TCM therapy combined with chemotherapy has certain advantages to improve thequality of life. Because of the limitation of the methodology quality and sample size of the adopted documents,the above conclusions have to be confirmed by more high-quality evidence based medical researches.
Objective To have systematic reviews about TCM therapy( Invigorating Qi and Expelling Phlegm) combined with chemotherapy on quality of life of patients with non-small-cell lung cancer( NSCLC) at stages Ⅲ-Ⅳ. Methods Such databases as Pub Med,the cochrane library,CNKI,VIP,EM base,Wan Fang and CBM were electronically searched to collect the randomized controlled trials( RCT) about TCM therapy combined with chemotherapy compared with single chemotherapy. We appraised the quality of the data and used Rev Man 5. 3 to get the Meta-analysis. Results Totally10 RCTs involving 604 cases were included. The results of meta-analysis showed that the TCM therapy combined with chemotherapy can significantly improve the effective rate[OR = 1. 78,95% CI( 1. 23,2. 57),P < 0. 00001],improvementrate of life quality[OR = 3. 08,95% CI( 2. 02,4.71),P < 0. 00001]and improvement of fatigue reliving rate[OR = 0. 15,95% CI( 0. 06,0. 38),P < 0. 00001],the differences had statistical significance. And there was no significant difference in the improvement of chest pain reliving rate[OR = 1. 47,95% CI( 0. 87,2. 48),P = 0. 15]. Conclusion Compared with the pure chemotherapy,the TCM therapy combined with chemotherapy has certain advantages to improve thequality of life. Because of the limitation of the methodology quality and sample size of the adopted documents,the above conclusions have to be confirmed by more high-quality evidence based medical researches.
引文
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[5]陈学彰,王艳杰,田华琴,等.益气除痰法结合化疗治疗中晚期非小细胞肺癌的临床疗效观察[J].中国医药指南,2012:10(19):332.
[6]关洁珊,欧阳明子,肖志伟,等.益气除痰方防治化疗相关性疲劳的疗效观察[J].辽宁中医杂志,2016,43(6):1211.
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[11]季兴祖.益气除痰散结法治疗老年中晚期非小细胞肺癌的临床研究[D].广州中医药大学硕士学位论文,2014.
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[13]杨新妹,徐玉芬,宋斌斌,等.益气化痰方联合化疗对晚期非小细胞肺癌患者临床疗效、不良反应以及生存质量的影响[J].中华中医药学刊,2016,34(5):1037.
[14]李明.益气化瘀法配合化治疗晚期非小细胞肺癌的临床研究[D].山东中医药大学博士学位论文,2008.
[15]孙燕,周际昌.临床肿瘤内科手册[M].北京:人民卫生出版社,2003:571.
[16]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科学技术出版社,2002:220.
[17]林丽珠,王淑美,周京旭.益气除痰方对脾虚LEWIS肺癌小鼠生存期及PRDX-1,PRDX-6表达的影响[J].中国中西医结合杂志,2011,31(1):99.
[18]Bian Z,Liu B,Moher D,et al.Consolidated standards of reporting trials(CONSORT)for traditional Chinese medicine:current situation and future development[J].Front Med,2011,5(2):171.
[2]Hubbs JL,Boyd JA,Hollis D,et al.Factors associated with the development of brain metastases:analysis of 975 patients with early stage nonsmall cell lung cancer[J].Cancer,2010,116(21):5038.
[3]吴一龙.非小细胞肺癌国际分期的修订和现代治疗策略[J].国外医学·肿瘤学分册.1998,25(6):353.
[4]周岱翰,林丽珠,周宜强,等.益气除痰法延长非小细胞肺癌中位生存期的作用[J].中医杂志,2005,46(8):600.
[5]陈学彰,王艳杰,田华琴,等.益气除痰法结合化疗治疗中晚期非小细胞肺癌的临床疗效观察[J].中国医药指南,2012:10(19):332.
[6]关洁珊,欧阳明子,肖志伟,等.益气除痰方防治化疗相关性疲劳的疗效观察[J].辽宁中医杂志,2016,43(6):1211.
[7]杜华福.益肺方联合化疗治疗中晚期非小细胞肺癌临床研究[D].广州中医药大学博士学位论文,2012.
[8]林丽珠.益气除痰法提高老年肺癌生存期的前瞻性研究及预后分析[D].广州中医药大学博士学位论文,2006.
[9]纪国义.益气除痰法与化疗联合治疗中晚期非小细胞肺癌的临床观察[J].中国继续医学教育,2015,7(25):210.
[10]陈聪博.益气除痰法治疗老年Ⅲ、Ⅳ期非小细胞肺癌的临床研究[D].广州中医药大学硕士学位论文,2007.
[11]季兴祖.益气除痰散结法治疗老年中晚期非小细胞肺癌的临床研究[D].广州中医药大学硕士学位论文,2014.
[12]阮氏秋恒.益气化痰法治疗老年晚期非小细胞肺癌临床观察[D].广州中医药大学博士学位论文,2012.
[13]杨新妹,徐玉芬,宋斌斌,等.益气化痰方联合化疗对晚期非小细胞肺癌患者临床疗效、不良反应以及生存质量的影响[J].中华中医药学刊,2016,34(5):1037.
[14]李明.益气化瘀法配合化治疗晚期非小细胞肺癌的临床研究[D].山东中医药大学博士学位论文,2008.
[15]孙燕,周际昌.临床肿瘤内科手册[M].北京:人民卫生出版社,2003:571.
[16]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科学技术出版社,2002:220.
[17]林丽珠,王淑美,周京旭.益气除痰方对脾虚LEWIS肺癌小鼠生存期及PRDX-1,PRDX-6表达的影响[J].中国中西医结合杂志,2011,31(1):99.
[18]Bian Z,Liu B,Moher D,et al.Consolidated standards of reporting trials(CONSORT)for traditional Chinese medicine:current situation and future development[J].Front Med,2011,5(2):171.