Zhang Haiming, Zhang Junli, Ding Hao, Chen Rui, Liang Fengxia
J Tradit Chin Med. 2016 Jun;36(3):261-70. doi: 10.1016/s0254-6272(16)30037-1.
To investigate the clinical efficacy and safety of Tongguanteng (Radix seu Herba Marsdeniae Tenacissimae) extract combined with chemotherapy in the treatment of advanced non-small cell lung cancer (NCSLC) compared with chemotherapy alone.
Databases including Chinese National Knowledge Infrastructure, China Biology Medicine Disc, Wanfang, and MEDLINE were searched until April 1, 2014. Two assessors independently reviewed each trial. The primary outcome was the effective rate (ER) of Tongguanteng (Radix seu Herba Marsdeniae Tenacissimae) extract combined with chemotherapy. The secondary outcomes included quality of life improvement rate (QOLIR) and adverse reactions. Statistical calculations were performed by using Cochrane Collaboration Review Manager 5.2.
A total of 888 patients from 15 studies, 13 randomized controlled trials (RCT) and two controlled clinical trials, were included. Compared with chemotherapy alone, Tongguanteng (Radix seu Herba Marsdeniae Tenacissimae) extract plus chemotherapy significantly improved ER [Risk ratio (RR) = 1.32, 95% CI, (1.14, 1.54)] (based on 15 studies) and QOLIR [RR = 2.04, 95% CI, (1.69, 2.47)] (based on 13 studies). Compared with chemotherapy alone, Tongguanteng (Radix seu Herba Marsdeniae Tenacissimae) extract plus chemotherapy significantly inhibited chemotherapy-induced white blood cell decline [RR = 0.79, 95% CI, (0.70, 0.90) (based on 10 studies), chemotherapy-induced platelet decline [RR = 0.77, 95% CI, (0.60, 0.98)] (based on 8 studies), and significantly alleviated nausea and vomiting (NV) [RR = 0.83, 95% CI, (0.71, 0.97)] (based on 7 studies). There was no significant difference in hemoglobin decline between the two therapies [RR = 0.88, 95% CI, (0.70, 1.09)] (based on 6 studies).
This Meta-analysis suggests that Tongguanteng (Radix seu Herba Marsdeniae Tenacissimae) extract combined with chemotherapy may be more efficacious in the treatment of advanced NSCLC than chemotherapy alone. This effect includes enhancing ER and QOLIR, and weakening chemotherapy toxicity. However, large-scale RCTs are required to further investigate the short- and long-term effects of Tongguanteng (Radix seu Herba Marsdeniae Tenacissimae) extract.
探讨通关藤提取物联合化疗与单纯化疗相比，在治疗晚期非小细胞肺癌（NSCLC）中的临床疗效及安全性。
检索中国知网、中国生物医学文献数据库、万方数据库及MEDLINE等数据库，检索截至2014年4月1日的文献。两名评估者独立审查每项试验。主要结局是通关藤提取物联合化疗的有效率（ER）。次要结局包括生活质量改善率（QOLIR）和不良反应。采用Cochrane协作网系统评价软件Review Manager 5.2进行统计分析。
共纳入15项研究中的888例患者，其中13项随机对照试验（RCT）和2项对照临床试验。与单纯化疗相比，通关藤提取物联合化疗显著提高了ER[风险比（RR）=1.32，95%可信区间（CI），（1.14，1.54）]（基于15项研究）和QOLIR[RR = 2.04，95% CI，（1.69，2.47）]（基于13项研究）。与单纯化疗相比，通关藤提取物联合化疗显著抑制化疗引起的白细胞下降[RR = 0.79，95% CI，（0.70，0.90）]（基于10项研究）、化疗引起的血小板下降[RR = 0.77，95% CI，（0.60，0.98）]（基于8项研究），并显著减轻恶心和呕吐（NV）[RR = 0.83，95% CI，（0.71，0.97）]（基于7项研究）。两种治疗方法在血红蛋白下降方面无显著差异[RR = 0.88，95% CI，（0.70，1.09）]（基于6项研究）。
本Meta分析表明，通关藤提取物联合化疗治疗晚期NSCLC可能比单纯化疗更有效。这种效果包括提高ER和QOLIR，以及减轻化疗毒性。然而，需要大规模的随机对照试验进一步研究通关藤提取物的短期和长期疗效。
