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目的评价中西医结合治疗小细胞肺癌的疗效和安全性。方法检索Pubmed数据库、中文科技期刊数据库、中国生物医学文献数据库、中国期刊全文数据库、万方数据库,纳入中药联合化疗或放化疗治疗与单用化疗或放化疗治疗的随机对照试验为研究对象,根据Cochrane协作网质量评价标准提取资料,采用Revman5.0软件进行资料分析,结局的效应指标为近期疗效、生活质量、不良反应和生存率。结果共纳入24篇研究1845例小细胞肺癌患者,中西医结合治疗组966例,西医对照组879例。17项试验显示中西医结合治疗组近期疗效、11项试验显示中西医结合治疗组生活质量改善率、5项试验显示中西医结合治疗组患者1、3、5年生存率,均高于西医对照组(P<0.05或P<0.01);15项试验显示中西医结合治疗组骨髓抑制发生率、13个试验显示中西医结合治疗组胃肠反应发生率,均低于西医对照组(P<0.01)。结论中西医结合治疗小细胞肺癌较单纯西医治疗显示出疗效更优的趋势,并能减少不良反应、提高患者生存质量、延长生存期。鉴于纳入的研究质量较低,有必要进行更多设计严谨的大样本、多中心试验。
Objective To evaluate the efficacy and safety of integrated traditional Chinese and western medicine in the treatment of small cell lung cancer. Methods The randomized controlled trials of Pubmed, Chinese Sci-tech Periodicals Database, Chinese Biomedical Literature Database, Chinese Journal Full-text Database, Wanfang Database were included in this study. The randomized controlled trials of combined chemotherapy or radiotherapy and chemotherapy with chemotherapy or radiotherapy and chemotherapy were included. Cochrane Collaboration network quality evaluation criteria extracted data, the use of Revman5.0 software for data analysis, the outcome of the indicators for the efficacy of short-term efficacy, quality of life, adverse reactions and survival rates. Results A total of 24 studies of 1845 patients with small cell lung cancer, 966 cases of Integrative Medicine and 879 cases of Western Medicine were included. Seventeen trials showed the short-term curative effect of Integrative Medicine, 11 trials showed the improvement of quality of life in Integrative Medicine group, and five trials showed that the 1, 3, 5-year survival rate of Integrative Medicine group were higher than Western medicine control group (P <0.05 or P <0.01). Fifteen trials showed the incidence of myelosuppression in the combined traditional Chinese and western medicine treatment and 13 trials showed that the incidence of gastrointestinal reactions in the combined traditional Chinese and Western medicine treatment group was lower than that in the western medicine control group (P <0.01 or P <0.01) ). Conclusion The treatment of small and medium-sized lung cancer with traditional Chinese and western medicine shows a better curative effect than western medicine alone, and can reduce side effects, improve patients’ quality of life and prolong survival. Given the low quality of the studies included, it is necessary to conduct more carefully designed large sample, multicenter trials.