参芪扶正注射液联合化疗对晚期非小细胞肺癌患者免疫功能影响的Meta分析

Meta-analysis of Effect of Shenqi Fuzheng Injection Combined with Chemoth-erapy on Immune Function in Patients with Advanced NSCLC

关键词:  参芪扶正注射液  非小细胞肺癌  化疗  免疫功能  Meta分析

Key words:  Shenqi Fuzheng Injection  non-small cell lung cancer  chemotherapy  immune function  Meta-analysis

摘要:

目的 系统评价参芪扶正注射液(Shengqi Fuzheng Injection，SFI)联合化疗对晚期非小细胞肺癌(non-small cell lung cancer，NSCLC)患者免疫功能的影响。方法 检索数据库，包括Pubmed、The Cochrane Library、CNKI、VIP、Wanfang Data、CBM等，纳入所有与SFI联合化疗对晚期NSCLC患者免疫功能影响相关的随机对照试验。采用Cochrane系统评价方法进行文献评价，由2名研究者独立评价研究并交叉核对纳入研究的质量，采用RevMan 5.3软件进行Meta分析。结果 纳入本次研究的RCTs共有18个，合计1 370例患者。Meta分析结果显示，与单纯化疗相比，SFI联合化疗组的免疫指标CD3⁺、CD4⁺、CD4⁺/CD8⁺、NK细胞显著提高，其SMD和95%CI分别为[3.25，(2.23，4.27)，P<0.01]，[3.02，(2.16，3.87)，P<0.01]，[1.3，(0.89，1.70)，P<0.01]，[1.74，(1.15，2.33)，P<0.01]，CD8⁺未见明显差异[SMD=0.32，95%CI=(-0.53，1.17)，P=0.46]。结论 SFI联合化疗在增强晚期NSCLC患者免疫力方面具有显著的临床意义，然而仍需要高质量、大样本的系统评价予以指导临床。

Abstract:

OBJECTIVE To systematically evaluate the effect of the Shenqi Fuzheng Injection(SFI) combined with chemotherapy on immune function in treatment of advanced non-small cell lung cancer(NSCLC). METHODS Through searching the Pubmed, the Cochrane Library, CNKI, VIP, Wangfang Data, CBM, recruited randomized controlled trials(RCTs) related to the immune impact of SFI combined with chemotherapy for advanced NSCLC. The quality of included studies was assessed by 2 independent researchers according to the criteria recommended by the Cochrane Collaboration’s Interventions and Meta analyses was conducted using RevMan5.3 software. RESULTS A total of 18 randomized controlled trials involving 1 370 patients were included in the study. The result of Meta analysis showed: the immune parameters of SFI plus chemotherapy group such as CD3⁺, CD4⁺, CD4⁺/CD8⁺, NK cells were significantly higher than chemotherapy group. Its SMD and 95%CI were [3.25, (2.23, 4.27), P<0.01], [3.02, (2.16, 3.87), P<0.01], [1.3, (0.89, 1.70), P<0.01], [1.74, (1.15, 2.33), P<0.01]. The difference between 2 groups had no statistical significance in immune parameters CD8⁺[SMD=0.32, 95%CI=(-0.53,1.17), P=0.46]. CONCLUSION SFI combined with chemotherapy has significant clinical value in improving the immune function of NSCLC patients. However, more high-quality and big-sample RCTs are required to be evaluated systematically.