血府逐瘀方剂辅助治疗肺癌的Meta分析
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国家自然科学基金项目(81774289,82074402);国家重点研发计划项目(2018YFC1707405);中国中医科学院科技创新工程项目(CI2021A01802)


Meta-analysis of Xuefu Zhuyu Decoction as Adjuvant Treatment for Lung Cancer
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    摘要:

    目的:评价血府逐瘀方剂辅助治疗肺癌的临床疗效以及凝血功能的改善情况。方法:检索Pubmed、Embase、Cochrane Library、国家知识基础设施数据库(CNKI)、中国学术期刊数据库(CSPD)、中文科技期刊数据库(CCD)、中国生物医学文献(CBM)数据库,检索时间限定为建库至2020年3月。使用Cochrane评价手册中的风险偏倚评估工具评价文献质量后纳入Meta分析。结果:共纳入15篇随机对照试验文献。Meta分析结果显示,临床疗效(OR=2.113,95%CI为1.627~2.745,P<0.05),对其及病理类型及対照度干预措施的不同进行亚组分析发现,生命质量(MD=7.05,95%CI为6.06~8.04,P<0.05);中医证候疗效(OR=4.817,95%CI为3.010~7.710,P<0.05)。凝血功能及血液流变学指标I2均>50%,具有较强异质性。结论:血府逐瘀方剂辅助治疗肺癌有着一定的临床疗效,可提高患者的生命质量,减轻其血瘀证候,对于高凝状态肺癌患者,可改善患者异常的凝血指标(PLT、FIB、D-Dimer、APTT、PT),并且可降低患者的全血黏度及血浆黏度。考虑纳入文献质量不高,此结论仍需要高质量的临床随机对照试验进行验证。

    Abstract:

    To evaluate the clinical efficacy of Xuefu Zhuyu Formula in the adjuvant treatment of lung cancer and the improvement of coagulation function.Methods:Pubmed,Embase,Cochrane Library,CBM,CNKI,Wanfang and VIP databases were searched from the establishment of each database to March 2020.Literature quality was evaluated using the risk bias assessment tool in the Cochrane Review Manual and included in the meta-analysis.Results:A total of 15 randomized controlled trials were included.Meta-analysis showed clinical efficacy(OR=2.113,95%CI(1.627,2.745,P<0.05),indicating that Xuefu Zhuyu Formula had certain advantages in the adjuvant treatment of lung cancer patients,and subgroup analysis was conducted for its and pathological types,and for different adjustability interventions.Quality of life(MD=7.05,95%CI(6.06,8.04,P<0.05); the curative effect of TCM syndromes(OR=4.817,95%CI(3.010,7.710,P<0.05) indicated that Xuefu Zhuyu Formula could improve the quality of life and TCM syndromes of patients.Both coagulation function and hemorheology index I2 were>50%,indicating strong heterogeneity.Sensitivity analysis was conducted respectively,and after removing single studies one by one,fixed effect combined with effect size was applied,indicating that all outcome indexes were improved to varying degrees,except for APTT,where P=0.41>0.05,indicating no statistical significance.Conclusion:Xuefu Zhuyu Formula has certain clinical efficacy in the adjuvant treatment of lung cancer,which can improve the quality of life of patients and alleviate their blood stasis syndrome.For patients with hypercoagulable lung cancer,it can improve the abnormal coagulation indicators(PLT,FIB,D-Dimer,APTT,PT),and reduce the whole blood viscosity and plasma viscosity of patients.Considering the low quality of the included literature,this conclusion still needs to be verified by a large number of high-quality randomized controlled clinical trials.

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卢泰成,于靖文,李娟,李杰,许博文.血府逐瘀方剂辅助治疗肺癌的Meta分析[J].世界中医药,2022,(02).

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  • 收稿日期:2020-05-19
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  • 在线发布日期: 2022-02-14
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