| ObjectiveTo systematically evaluate the clinical efficacy of traditional Chinese medicine treatment compared with the best supportive care in the treatment of advanced non-small cell lung cancer.Furthermore,the data mining of the prescriptions of randomized controlled trials with simple Chinese medicine decoction for curative effect was carried out,the medication characteristics of modern doctors were analyzed,and the characteristics of high-frequency drugs,drugs and drugs were obtained,and clustering prescriptions and drug groups were mined out,so as to guide clinical practice.MethodThrough searching CNKI,VIP,Wanfang,CBM,Pub Med,coerrane library and EMBASE,the retrieval period is from the establishment of the database to September 30,2019.The randomized controlled trials that met the inclusion and exclusion criteria were selected,and the literature quality was evaluated and the data were extracted The results were analyzed by manager 5.3,in which the relative risk(RR)was used as the secondary variable.According to the results of heterogeneity test,the results of the included studies were meta analyzed by fixed or random effect model,and the results were analyzed for sensitivity and publication bias.The outcome indicators included:solid tumor stability rate,improvement rate of quality of life,improvement rate of TCM symptoms,and weight stability rate.According to the inclusion and exclusion criteria,the literatures that can be used for the analysis of drug use rules were selected from the retrieval results in the previous part.The prescriptions in the literature were extracted,and the names of traditional Chinese medicine were standardized.The database of prescription analysis was established,and SPSS statistics was used 20.0,the most frequently used drugs,drug classification,drug characteristics,as well as the cluster formula closely related to compatibility were obtained by frequency analysis and cluster analysis.SPSS modeler 18.0 was used to analyze the association rules of drugs,and the association rules of two herbs,three herbs and four herbs were obtained.ResultsA total of 14 randomized controlled trials were included in the meta-analysis.The total number of 14 studies was 831 cases,including 415 cases in the traditional Chinese medicine group and 416 cases in the control group.Meta analysis showed that compared with the best supportive treatment group,the traditional Chinese medicine group could stabilize the tumor:RR=1.55,95%CI[1.21-2.00],z=3.41,P=0.00006;I~2=59%,P=0.009.The quality of life was significantly improved in the TCM group:RR=2.04,95%CI[1.60-2.62],z=5.66,P<0.00001;I~2=0%,P=0.54.TCM group can effectively improve TCM syndrome:RR=1.81,95%CI[1.41-2.33],z=4.64,P<0.00001;I~2=24%,P=0.26.Chinese medicine group can effectively stabilize body weight:RR=1.47,95%CI[1.23-1.75],z=4.28,P<0.00001;I~2=0%,P=0.66.The results were statistically significant.A total of 34 literatures were included in the study of medication regularity analysis,including 38 prescriptions,114 kinds of drugs,and the total frequency of drug use was 481.The top five drugs were Astragalus membranaceus(25 times,65.79%),Atractylodes macrocephala(22 times,57.89%),Hedyotis diffusa(22 times,57.89%),Poria Cocos(21 times,55.26%),liquorice(16 times,42.11%).The top five categories of traditional Chinese medicine were tonifying deficiency medicine(172 times,35.76%),heat clearing medicine(89 times,18.50%),antitussive,expectorant and antiasthmatic drugs(56 times,11.64%),drugs for promoting blood circulation and removing blood stasis(45 times,9.36%),and drugs for diuresis and dampness(35 times,7.28%).The top three drug properties were cold(171 times,36.00%),warm(142 times,29.89%),flat(113 times,23.79%),sweet(311,39.52%),bitter(258,32.78%),spicy(141,17.92%),and spleen(245,20.68%),lung(241,20.34%)and stomach(185,15.61%)were the top three.Three clustering squares were obtained.16 association rules of two herbs,63 association rules of three herbs and 38 association rules of four herbs were found.Conclusion1.From the perspective of meta-analysis,it is further verified that compared with the best supportive treatment,traditional Chinese medicine treatment has certain advantages in stabilizing tumor body,improving quality of life,improving clinical symptoms and stabilizing body weight in patients with advanced non-small cell lung cancer,which needs to be further confirmed by high-quality prospective randomized controlled trials.2.With the method of data mining,it is confirmed that the traditional Chinese medicine treatment of advanced non-small cell lung cancer mainly focuses on tonifying deficiency,paying attention to the treatment of lung and spleen,Qi and Yin simultaneously,eliminating pathogenic factors and detoxification,and paying attention to the combination of dampness and phlegm,and removing blood stasis. |
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