中医药治疗中晚期非小细胞肺癌临床研究的Meta分析

摘要

目的：客观评价中医药治疗中晚期非小细胞肺癌的临床疗效。方法计算机搜索2002年~2012年国内外各种医学期刊、中国重要会议论文全文数据库以及万方、维普、中国知网、Medline等医学数据库,并结合手工搜索相关杂志。按系统评价方法筛选RCT文献,进行质量评价并提取一年生存率、瘤体变化、生存质量评分的相关数据进行Meta分析。结果中药组相对化疗组,1年生存率情况：RR=1．44,95%CI(1．15,1．80)；瘤体有效率：RR=0．56,95%CI(0．44,0．71)；瘤体稳定率：RR=1．00,95%CI(0．93,1．07)；卡氏评分情况：RR=2．52,95%CI(2．05,3．08)。结论中医药治疗中晚期非小细胞肺癌在提高患者的一年生存率、卡氏评分方面较一线化疗方案具有一定的优势。瘤体有效率方面存在劣势,但因纳入研究的文献存在发表性偏倚,其可靠性仍需进一步研究证实。中医药治疗在瘤体稳定率方面与一线化疗方案相当,结果具有客观真实性。%Objective To objectively evaluate the clinical efficacy of TCM treatment of non-small cell lung cancer in medium and advanced stages. Methods Domestic and foreign medical journals from 2002 to 2012, full-text database of Chinese conference papers and medical databases like Wanfang data, VIP, CNKI and Medline, etc. ,are searched with the help of computer, combined with manual search for related magazines. System evaluation methods were used to screen RCT literature, evaluate quality and ex-tract data including one year survival rate, tumor changes, life quality scores for Meta analysis. Results Compared with chemotherapy group, one year survival rate in TCM treatment group: RR=1. 44, 95%CI (1. 15, 1. 80);tumor with efficiency:RR=0. 56, 95%CI (0. 44, 0. 71);tumor body stable rate:RR=1. 00, 95%CI (0. 93, 1. 07);Karnofsky score:RR=2. 52, 95%CI (2. 05, 3. 08). Conclusion TCM treatment of non-small cell lung cancer in medium and advanced stages has certain advantages in improving patients’ one year survival rate and Karnofsky score compared with first-line chemotherapy. However, TCM treatment is at a disadvantage in tumor with efficiency. As the journals included in the study display publi-cation bias, the reliability of the results still needs further study. In tumor body stable rate, TCM treatment is the same as first-line chemotherapy, the results are objective and authentic.