中药复方联合放射疗法治疗鼻咽癌疗效的Meta分析

目的评价中药复方（益气养阴、清热活血方Yiqi Yangyin Qingre Huoxue decoction,YYQHD）联合放射疗法治疗鼻咽癌在减毒增效方面的疗效。方法采用Cochrane系统评价方法,电子检索Cochrane图书馆临床对照试验资料库（Cochrane Central Register of Controlled Trials,CENTRAL）、PubMed、EMBASE、中国生物医学文献数据库（CBM）、中文科技期刊全文数据库（CNKI）和中国期刊全文数据库（VIP）以及万方数据库等数据库2010年3月前所发表的相关文献。同时互联网检索Current Controlled Trial、Clinical Trials和中国临床试验注册网。手工检索部分肿瘤类核心期刊。采用Cochrane协作网推荐的＂偏倚风险评估＂工具,评估纳入研究的质量,使用RevMan 5.0.23.0软件对纳入的研究进行定量系统评价。结果最终纳入符合标准的中文文献9篇共795例患者。定量分析结果显示：与单纯常规放射治疗相比较,中药复方（YYQHD）联合常规放射治疗能显著提高肿瘤近期疗效、生存率,并且能显著减少放射治疗常见毒副反应的发生,从而提高放射治疗按时完成率确保放射治疗疗效、改善患者生存质量。结论虽现有研究尚不能得出可以将中药复方（YYQHD）作为标准治疗手段辅助放射治疗的结论,但提示益气养阴、清热活血类中药联合放射治疗治疗鼻咽癌是值得继续探索的研究方向,期待设计科学合理、高质量的多中心、大样本、双盲、随机对照临床试验以进一步验证其疗效。

Protective Effects of Decoction Plus Radiotherapy on Nasopharyngeal Carcinoma:A Meta-analysis of Randomized Controlled Trials

Objective To compare the efficacy of traditional Chinese medicine（TCM） plus radiotherapy（RT） with RT alone on nasopharyngeal carcinoma（NPC） by Yiqi Yangyin Qingre Huoxue decoction（YYQHD） through a meta-analysis of all available randomized controlled trials.Methods Literature retrieval was conducted using the Cochrane Library,PubMed,EMBASE,CBMdisk,CNKI,VIP,and Wanfang Database electronically.Relevant journals and conference proceedings were also hand-searched until March 31,2010.The quality of included studies was assessed according to the criteria recommended by the Cochrane handbook,and the Meta-analysis was performed for homogeneous studies using RevMan 5.0.23.0 Software.Results Basing on our search criteria,we found nine trials（795 patients） which all published in Chinese.Our results showed that TCM（YYQHD） plus RT compared with RT alone,improved immediate tumor response,survival,completion rate of RT,quality of life,and alleviation of adverse effect of patients with NPC.Conclusions Considering the limitations related to this Meta-analysis,it nevertheless presents credible evidence that TCM（YYQHD） plus RT is worthy of additional study.Therefore,further large-scale,muti-center,randomized,and double-blind trials are warranted.