A Systematic Review And Meta-analysis Of Randomized Clinical Trials To Assess The Effect Of Heat-clearing Traditional Chinese Medicines On The Incidence Of Radiation-induced Lung Injury

Objective This study aims to evaluate the effects of heat-clearing traditional Chinese medicine on patients undergoing radiotherapy with chest malignant tumor.Methods We searched the electronic databases(PIBMED,CNKI,CBM and Vi P)in order to obtain the RCT whose patients with chest malignant tumor and planning to undergo radiotherapy.The experimental group treated with heat-clearing traditional Chinese medicines and underwent radiotherapy,at the same time,the control group treated with radiotherapy alone.Trials could be no blinded.No language restriction was used.The methodological quality of trials was assessed by using the Cochrane Collaboration's tool.Meta-analysis?subgroup analysis,sensitivity analysis were conducted by using Stata12.0 software.Results 1.Twenty-three trials and 1679 patients were included.The included cases were disproportionately more males than females.Majority of the chest malignant tumor were cancer of lung.2.Based on the incidence of radiation pneumonia,23 cases were included.Results show that the morbility of radiation pneumonia of experimental group was lower than control group,the difference is significant(P<0.001).Subgroup analyses show that the risk of the patients whose observation time was the third month was higher than that of the first month(just at the end of radiotherapy),there was no statistic difference between two groups(P>0.05),however.The risk of the patients more than or equal to 60 years old may be more vulnerable to radiation pneumonia than that of the patients less than 60 years old,there was no statistic difference between two groups(P>0.05),either.3.After radiotherapy,the cytokine levels of TGF-?1?IL-6?TNF-?of experimental group were lower than control group,the difference is significant(P<0.001,P<0.001,P<0.001).4.Based on the traditional Chinese medicine symptom scale,the improvement of symptoms of experimental group were lower than control group,the difference is significant(P<0.05).5.Based on the Karnofsky scores,the life quality of experimental group were higher than control group,the difference is significant in continuous variable data(P<0.001),while there was no statistic difference in binary variable data(P>0.05).6.Based on the pulmonary function tests,the improvement of pulmonary function of experimental group were higher than control group,the difference is significant(P<0.05),but there is a lack of samples.7.Heat-clearing Traditional Chinese Medicines were confirmed little or no side effect.Conclusion 1.Heat-clearing Traditional Chinese Medicines shall benefit the patients with chest malignant tumor and planning to undergo radiotherapy and lower the risk of morbidity of radiation-induced lung injury 2.Heat-clearing Traditional Chinese Medicines may reduce inflammation by down-regulate the expression of the inflammatory cytokines(TGF-?1?IL-6?TNF-?,etc).3.Heat-clearing Traditional Chinese Medicines shall improve the syndrome and enhance the life quality of patients,and show good security.