[关键词]
[摘要]
目的 通过系统评价的方法评价补益类中药对肿瘤患者放射性肺炎的治疗作用。方法 检索Pubmed、Cochrane Library、Embase、中国期刊全文数据库(CNKI)、维普中文科技期刊全文数据库(VIP)、中国生物医学文献数据库(CBM)、万方数据库等中英文数据库,检索时间从建库至2017年9月1日。用Revman 5.0软件对纳入研究进行方法学质量评价,用Stata 12.0对主要指标放射性肺炎的疗效,辅助指标包括影像学改变、糖皮质激素使用时间、生活质量、免疫功能、肺功能以及细胞因子水平等进行分析。结果 共纳入47项研究,共3 071例患者。与对照组相比,使用补益药能有效治疗放射性肺炎[OR=3.778,95% CI(3.098,4.609),P=0.000],提高患者的生活质量[OR=3.509,95% CI(2.655,4.638),P=0.000],减少激素使用时间[WMD=-6.313,95% CI(-9.349,-3.276),P=0.000],改善患者用力呼气量与用力肺活量的比值,降低转化生长因子-β(TGF-β)水平;但对肺活量(VC)、第1秒用力呼气量(FEV1)、免疫功能的改善作用不明显。亚组分析及回归分析显示治疗效果与使用补益药的种类、是否联合使用激素、用药总时长以及患者的肿瘤类型无关。结论 补益类中药可使放射性肺炎患者的症状及影像学检查均得到改善,并能改善患者的生活质量,减少激素的使用时间。
[Key word]
[Abstract]
Objective To evaluate the therapeutic effect of tonic traditional Chinese medicine on radiation pneumonitis by means of Meta-analysis. Methods Pubmed, Cochrane Library, Embase, CNKI, VIP, CBM, and Wanfang were retrieved online from their inception to September 1, 2017. Revman 5.0 software was used to assess the bias of the included studies, and Stata 12.0 was used to evaluate the extraction of the therapeutic effects of radiation pneumonitis. Auxiliary indicators include imaging changes, the use time of glucocorticoid, the quality of life, immune function, lung function, and cytokine levels. Results A total of 47 studies involving 3071 patients were included, and methodological quality has moderate bias. Compared with the control group, Chinese tonic medicine can be effective in the treatment of radiation pneumonitis[OR=3.778,95% CI(3.098,4.609), P=0.000], improve the quality of life[OR=3.509, 95% CI(2.655,4.638), P=0.000], reduce the glucocorticoid use time[WMD=-6.313, 95% CI(-9.349,-3.276), P=0.000], improve the level of FEV1/VC, and reduce the level of transforming growth factor-β (TGF-β). But for vital capacity (VC), the improvement of forced expiratory volume in one second (FEV1) and immune function is not obvious. Subgroup analysis and regression analysis showed that the effects of treatment were not related to the type of tonic drugs used, whether they were used in combination with glucocorticoid, the total duration of the medication, and the type of tumor of the patient. Conclusion Chinese tonic medicine can improve the symptoms and pulmonary imaging of patients who have radiation pneumonitis, improve the quality of life, and reduce the use time of glucocorticoid.
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[基金项目]
辽宁省科技厅"产业共性技术创新平台"资助项目(2014226033)