常用中药注射剂联合吉西他滨与顺铂治疗中晚期非小细胞肺癌Meta分析

Meta-analysis of common Chinese medicine injections combined with gemcitabine and cisplatin in the treatment of advanced non-small-cell lung cancer

关键词:  吉西他滨  顺铂  非小细胞肺癌  网状Meta分析  中药注射剂

Key words:  gemcitabine  cisplatin  non-small-cell lung cancer  network Meta-analysis  Chinese medicine injection

摘要:

[目的] 运用网状Meta分析评价艾迪注射液、参芪扶正注射液、复方苦参注射液、康艾注射液、康莱特注射液、消癌平注射液6种常用中药注射剂（CMI）联合吉西他滨与顺铂（GP）治疗中晚期非小细胞肺癌（NSCLC）的临床疗效及安全性。[方法] 计算机检索中国知网（CNKI）、万方数据知识服务平台（Wanfang）、维普数据库（VIP）、中国生物医学文献服务系统、PubMed、EMbase、Cochrane Library等数据库，检索时间截止至2022年12月。采用RoB2 Excel软件中Cochrane偏倚风险工具评估选定研究的偏倚风险。使用Stata 15.0软件制作网状图、联赛表、累积排名下的曲线面积及漏斗图。[结果] 共纳入22篇符合条件的随机对照试验。以GP为共同干预措施，艾迪注射液、康莱特注射液联合GP能够有效改善客观缓解率（ORR）；艾迪注射液、参芪扶正注射液、复方苦参注射液、康艾注射液、康莱特注射液联合GP能够有效提高CD3⁺细胞占比、CD4⁺T细胞占比；艾迪注射液、参芪扶正注射液、康艾注射液、康莱特注射液联合GP能够有效提高CD4⁺/CD8⁺T细胞比例；艾迪注射液、参芪扶正注射液、复方苦参注射液、康艾注射液、康莱特注射液、消癌平注射液联合GP能够有效降低白细胞减少发生率；复方苦参注射液、康艾注射液、康莱特注射液联合GP能够有效降低血小板减少发生率。[结论] CMI联合GP能够有效提高中晚期NSCLC的临床疗效及安全性。在改善ORR、降低白细胞减少发生率、提高CD4⁺T细胞占比及CD4⁺/CD8⁺T细胞比例方面，康莱特注射液最佳；在提高CD3⁺T细胞占比方面，艾迪注射液最佳；在降低血小板减少发生率方面，复方苦参注射液最佳。

Abstract:

[Objective] To evaluate clinical efficacy and safety of six common Chinese medicine injections（CMI） of Aidi Injection，Shenqi Fuzheng Injection，Compound Kushen Injection，Kang’ai Injection，Kanglaite Injection and Xiaoaiping Injection combined with gemcitabine and cisplatin（GP） in the treatment of advanced non-small-cell lung cancer（NSCLC） by network Meta-analysis. [Methods] The databases of CNKI，Wanfang，VIP，China Biomedical Literature Service system，PubMed，Embase and Cochrane Library were searched by computer until December，2022. The Cochrane bias risk tool in the RoB2 Excel tool software was used to assess the bias risk among the selected studies. The Stata 15.0 software was used to make network diagram，league table，surface under the cumulative curve ranking area and funnel plot. [Results] A total of 22 eligible randomized controlled trials were included in this study. The results of network Meta-analysis showed that，with GP as a co-intervention，Aidi Injection and Kanglaite Injection combined with GP could effectively improve the objective response rate（ORR）. Aidi Injection， Shenqi Fuzheng Injection，Compound Kushen Injection，Kang’ai Injection and Kanglaite Injection combined with GP could effectively increase the ratio of CD3⁺ and CD4⁺ T cells. Aidi Injection，Shenqi Fuzheng Injection，Kang’ai Injection and Kanglaite Injection combined with GP could effectively increase the ratio of CD4⁺/CD8⁺ T cells. Aidi Injection，Shenqi Fuzheng Injection，compound Kushen Injection，Kang’ai Injection，Kanglaite Injection and Xiaoaiping Injection combined with GP could effectively reduce the incidence of leukopenia. Compound Kushen Injection，Kang’ai Injection and Kanglaite Injection combined with GP could effectively reduce the incidence of thrombocytopenia. [Conclusion] CMI combined with GP can effectively improve the clinical efficacy and safety of advanced NSCLC. In terms of improving ORR，reducing the incidence of leukopenia，increasing the ratio of CD4⁺ T cells and CD4⁺/CD8⁺ T cells，Kanglaite Injection is the best. In terms of increasing the ratio of CD3⁺ T cells，Aidi Injection is the best. In terms of reducing the incidence of thrombocytopenia，Compound Kushen Injection is the best.