摘要
目的系统评价中西医结合干预疗法对肺癌患者生活质量的影响。方法计算机检索多个国内外中英文数据库,收集关于中医药或中西医结合疗法对中晚期肺癌患者生活质量影响的临床随机对照试验(RCT),检索时间截止2018年10月。根据本研究的纳入标准,由2名研究员独立对文献进行筛选,提取数据,质量评价,应用Review Manager 5.3软件系统分析,主要效应指标为实体瘤近期疗效、生活质量积分、卡氏评分(KPS)、中医症候积分及体重状况。结果最终纳入16项RCTs,共1123例肺癌患者。Meta分析结果显示:中医药治疗中晚期肺癌能明显改善患者总体生活质量,而在疼痛、恶心呕吐以及经济困难方面差异无统计学意义(P>0.05);但提高患者的近期疗效[OR=1.66,95%CI(1.14,2.44),Z=2.61(P=0.009<0.05)];改善中医症候积分[MD=-7.21,95%CI(-10.78,-3.63),Z=3.95(P<0.0001)];提高KPS评分[MD=7.86,95%CI(6.62,9.10),Z=12.44(P<0.00001)];增加患者的体重[MD=2.72,95%CI(1.42,4.02),Z=4.09(P<0.0001)]方面效果明显优于对照组。结论中西医结合干预疗法能明显改善肺癌患者的症状、提高生活质量,为中医药扶正抗癌提供了临床依据。但由于所纳入研究的质量不高,需谨慎对待本次研究结果,仍需开展大样本、多中心、高质量的随机对照试验进一步证实其临床疗效。
Objective To systematically evaluate the effect of integrated traditional Chinese and Western medicine intervention therapy on the quality of life of lung cancer patients.Methods A number of Chinese and English databases were searched by computer to collect randomized controlled trials(RCTs)on the impact of traditional Chinese medicine or integrated Chinese and Western medicine on the quality of life of patients with advanced lung cancer.The searching time was up to October 2018.According to the inclusion criteria,two researchers independently screened the literature,extracted data and evaluated the quality.The main effect indicators were short-term curative effect of solid tumors,quality of life score,Kappa’s score(KPS),TCM symptom score and weight status by using Review Manager 5.3 software system analysis.Results A total of 1123 lung cancer patients were included in 16 RCTs.Meta-analysis showed that TCM treatment of advanced lung cancer could significantly improve the overall quality of life of patients,but there was no significant difference in pain,nausea and vomiting,and economic difficulties(P>0.05);but it could improve the short-term efficacy of patients[OR=1.66,95%CI(1.14,2.44),Z=2.61(P=0.009<0.05)];improve TCM syndrome score[MD=-7.21,95%CI(-10.78,-3.63)Z=3.95(P<0.0001);improving KPS score[MD=7.86,95%CI(6.62,9.10),Z=12.44(P<0.00001)];increasing patients’weight[MD=2.72,95%CI(1.42,4.02),Z=4.09(P<0.0001)]was significantly better than the control group.Conclusion Intervention therapy of integrated traditional Chinese and Western medicine can significantly improve the symptoms and quality of life of patients with lung cancer,which provides a clinical basis for strengthening and anti-cancer of traditional Chinese medicine.However,due to the low quality of the included studies,caution should be taken with regard to the results of this study.Large sample,multi-center,high-quality randomized controlled trials are still needed to further confirm its clinical efficacy.
作者
高雅婷
吴迪
李泽庚
童佳兵
张星星
杨勤军
Wu Di;Li Zegeng;Tong Jiabing;Zhang Xingxing;Yang Qinjun;Gao Yating(Graduate School of Anhui University of Traditional Chinese Medicine,Hefei 230012,China;Institute of Respiratory Disease Prevention and Treatment of Traditional Chinese Medicine,Anhui Academy of Chinese Medicine,Hefei 230012,China;First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230012,China)
出处
《世界科学技术-中医药现代化》
CSCD
北大核心
2020年第7期2246-2255,共10页
Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology
基金
中医药管理局重点实验室建设项目(国中药函[2009]95号):国家中医药管理局肺气虚证重点研究室,负责人:李泽庚
国家自然科学基金(81874431):基于mTORC1调节自噬相关复合体Beclin1/Bcl-2研究芪玉三龙汤抗非小细胞肺癌机制,负责人:李泽庚
安徽省自然科学基金项目(1808085QH256):基于基因干扰技术研究芪玉三龙汤抑制肺癌分子机制,负责人:张星星
关键词
肺癌
中西医结合疗法
生活质量
META分析
Lung cancer
Integrated traditional Chinese and Western medicine therapy
Quality of life
Meta-analysis
