目的 通过网状Meta分析评价6种常用口服中成药联合铂类化疗治疗非小细胞肺癌（non-small cell lung cancer，NSCLC）的疗效和安全性。方法 基于临床实践，选取6种肺癌患者常用口服中成药，即康莱特胶囊、复方红豆杉胶囊、紫龙金片、西黄丸（胶囊）、复方斑蝥胶囊、华蟾素片（胶囊），计算机检索中国知网、万方数据库、中国生物医学文献数据库及Pubmed、EMBase、Cochrane Library数据库，搜集该6种口服中成药联合铂类化疗对比单纯铂类化疗治疗NSCLC的随机对照试验（randomized controlled trial，RCT），检索时限为建库至2020年6月7日。由2位评价员独立筛选文献、提取数据并评价纳入文献的偏倚风险，采用Stata 13.0、Revman 5.3和GeMTC 0.14.3软件进行统计分析。结果 最后纳入55个RCT共计4221例NSCLC患者。网状Meta分析结果显示，以铂类化疗为共同干预措施，紫龙金片联合铂类治疗NSCLC的生活质量较单纯铂类治疗明显改善；复方斑蝥胶囊、紫龙金片、复方红豆杉胶囊、华蟾素片（胶囊）、康莱特胶囊、西黄丸（胶囊）联合铂类治疗NSCLC的疾病控制率明显高于单纯铂类治疗，其中复方斑蝥胶囊优于西黄丸（胶囊）；紫龙金片、复方红豆杉胶囊、复方斑蝥胶囊、华蟾素片（胶囊）联合铂类治疗NSCLC的消化道反应发生率明显低于单纯铂类治疗；复方斑蝥胶囊、紫龙金片、华蟾素片（胶囊）、复方红豆杉胶囊、西黄丸（胶囊）联合铂类治疗NSCLC的白细胞减少发生率明显低于单纯铂类治疗，其中紫龙金片优于康莱特胶囊，复方斑蝥胶囊优于康莱特胶囊、西黄丸（胶囊）；复方斑蝥胶囊、紫龙金片联合铂类治疗NSCLC的血红蛋白减少发生率明显低于单纯铂类治疗；复方斑蝥胶囊、复方红豆杉胶囊、华蟾素片（胶囊）、紫龙金片联合铂类治疗NSCLC的血小板减少发生率明显低于单纯铂类治疗，其中复方斑蝥胶囊优于西黄丸（胶囊）。结论 紫龙金片较其他中成药改善NSCLC患者生活质量更明显，复方斑蝥胶囊、紫龙金片、复方红豆杉胶囊的疾病控制率较好，紫龙金片降低消化道反应发生率疗效更佳，复方斑蝥胶囊降低血液毒性效果更好。

Objective To evaluate the clinical efficacy and safety of six common oral Chinese patent medicine combined with platinum-based chemotherapy for non-small cell lung cancer (NSCLC) by network Meta-analysis.Methods The literature about randomized controlled trials (RCTs) of six oral Chinese patent medicine combined with platinum-based chemotherapy for NSCLC were searched from CNKI, Wanfang, SinoMed, PubMed, Embase, and Cochrane Library databases. The research began from the establishment of the database to June 7, 2020. The literature was screened by two assessors independently. The data was extracted and the risk of bias of included articles was evaluated. Analysis was carried out by Stata 13.0, Revman 5.3 and GeMTC 0.14.3 software. Results A total of 55 RCTs involving 4221 cases of NSCLC patients were included. The network Meta-analysis results showed that the quality of life of Zilongjin Tablets (紫龙金片) combined with platinum-based chemotherapy for NSCLC were superior to that of simple chemotherapy. The disease control rate (DCR) of Banmao Capsules (复方斑蝥胶囊), Zilongjin Tablets, Hongdoushan Capsules (复方红豆杉胶囊), Huachansu Tablets (Capsules) (华蟾素片/胶囊), Kanglaite Capsules (康莱特胶囊), Xihuang Pills (Capsules) (西黄丸/胶囊) combined with platinum-based chemotherapy for NSCLC were superior to that of simple chemotherapy, among them, Banmao Capsules was better than Xihuang Pills (Capsules). The rate of digestive tract reaction of Zilongjin Tablets, Hongdoushan Capsules, Banmao Capsules, and Huachansu Tablets (Capsules) combined with platinum-based chemotherapy for NSCLC were lower than that of simple chemotherapy. The depression of WBC of Banmao Capsules, Zilongjin Tablets, Huachansu Tablets (Capsules), Hongdoushan Capsules and Xihuang Pills (Capsules) combined with platinum-based chemotherapy for NSCLC were lower than that of simple chemotherapy, among them, Zilongjin Tablets was better than Kanglaite Capsules, Banmao Capsules was better than Kanglaite Capsules and Xihuang Pills (Capsules). The reduction of HGB of Banmao Capsules and Zilongjin Tablets combined with platinum-based chemotherapy for NSCLC were lower than that of simple chemotherapy; The PLT reduction of Banmao Capsules, Hongdoushan Capsules, Huachansu Tablets (Capsules) and Zilongjin Tablets combined with platinum-based chemotherapy for NSCLC were lower than that of simple chemotherapy, among them, Banmao Capsules was better than Xihuang Pills. Conclusion In this study, Zilongjin Tablets can improve the quality of life much more better than other Chinese patent medicines. While Banmao Capsules, Zilongjin Tablets and Hongdoushan Capsules are better for DCR. Besides, Zilongjin Tablet can reduce digestive tract reaction and Banmao Capsules can decrease the occurrence of blood toxicity.

R285.6

浙江省名老中医郭勇学术传承与专科建设（201728号）；“十三五”浙江省中医药（中西医结合）重点学科建设计划项目（2017-XK-A09）