六君子汤联合化疗治疗中晚期NSCLC疗效的Meta分析

目的  系统评价六君子汤联合化疗治疗中晚期非小细胞肺癌(NSCLC)的疗效及不良反应。方法  检索PubMed、Embase、The Cochrane Library、中国知网、万方、维普、中国生物医学文献数据库有关六君子汤联合化疗(试验组)与单纯化疗(对照组)治疗中晚期NSCLC的随机对照试验(RCT)。采用RevMan5.3进行Meta分析。结果  共纳入16项RCT。Meta分析结果显示，临床疗效: RR=1.22, 95%CI(1.08, 1.38)，P < 0.05];生存质量: RR=1.60, 95%CI(1.11, 2.30), P < 0.05];KPS评分: MD=-1.93，95%CI(-2.93, -0.93)，P < 0.01];肿瘤灶疗效: RR=1.40, 95%CI(1.09, 1.79), P < 0.05];咳嗽: RR=0.31, 95%CI(0.17, 0.56), P < 0.05];消化道反应: RR=0.66, 95%CI(0.50, 0.87), P < 0.05];乏力: RR=0.36, 95%CI(0.19, 0.70), P < 0.05];白细胞减少: RR=0.69, 95%CI(0.55, 0.88), P < 0.05];癌胚抗原(CEA): MD=-2.91，95%CI(-4.20, -1.62)，P < 0.01];糖类抗原199(CA199): MD=-13.55, 95%CI(-14.56, -12.54), P < 0.05];鳞状细胞癌抗原(SCC-Ag): MD=-1.32，95%CI(-1.67-0.96)，P < 0.01];细胞角蛋白19(Cyfra21-1): MD=-6.01, 95%CI(-6.75, -5.27), P < 0.05];神经元特异性烯醇化酶(NSE): MD=-6.74, 95%CI(-7.06, -6.42), P < 0.05]。结论  六君子汤联合化疗能减轻中晚期NSCLC患者不良反应, 改善血清肿瘤标记物、血液学指标, 提高患者临床疗效以及患者生存质量等, 此数据仍需后期大量临床研究证实。 

Meta-Analysis of the Efficacy of Liujunzi Decoction Combined with Chemotherapy on Middle-Late Stage NSCLC

OBJECTIVE  To systematically evaluate the efficacy and adverse reactions of Liujunzi decoction combined with chemotherapy on middle-late stage non-small cell lung cancer (NSCLC).METHODS  The randomized controlled trials (RCT) of Liujunzi decoction combined with chemotherapy (treatment group) and chemotherapy alone (control group) for the treatment of middle-late stage NSCLC were reviewed in PubMed, Embase, The Cochrane Library, China National Knowledge Infrastructure, Wanfang data, VIP, and Chinese Biomedical Database. In addition, Meta-analysis was performed using RevMan5.3.RESULTS  A total of 16 RCTs were included. The results of Meta-analysis showed that clinical efficacy: RR=1.22, 95%CI(1.08, 1.38), P < 0.05]; quality of life: RR=1.60, 95%CI(1.11, 2.30), P < 0.05]; KPS score: MD=-1.93, 95%CI(-2.93, -0.93), P < 0.01]; efficacy on tumor-like lesions: RR=1.40, 95%CI(1.09, 1.79), P < 0.05]; cough: RR=0.31, 95%CI(0.17, 0.56), P < 0.05]; gastrointestinal reaction: RR=0.66, 95%CI(0.50, 0.87), P < 0.05]; lacking in strength: RR=0.36, 95%CI(0.19, 0.70), P < 0.05]; leukopenia: RR=0.69, 95%CI(0.55, 0.88), P < 0.05]; carcino-embryonic antigen (CEA): MD=-2.91, 95%CI(-4.20, -1.62), P < 0.01]; carbohydrate antigen 199 (CA199): MD=-13.55, 95%CI(-14.56, -12.54), P < 0.05]; squamous cell carcinoma antigen (SCC-Ag): MD=-1.32, 95%CI(-1.67-0.96), P < 0.01]; cytokeratin 19 (Cyfra211): MD=-6.01, 95%CI(-6.75, -5.27), P < 0.05]; neuronspecific enolase (NSE): MD=-6.74, 95%CI(-7.06, -6.42), P < 0.05].CONCLUSION  Liujunzi decoction combined with chemotherapy can alleviate the adverse reactions, reduce the serum tumor markers levels, improve the hematological examination results, increase the clinical efficacy, and better the quality of life in patients with middle-late stage NSCLC. However, those results still need to be confirmed by a large number of clinical studies in future.