Meta Analysis Of The Short-term Efficacy And Quality Of Life In The Treatment Of Advanced Lung Cancer With The Method Of Invigorating Qi And Activating Blood Circulation And Removing Stasis Combined With Chemotherapy

Objective: By using the meta analysis method of modern evidence-based medicine,the short-term curative effect,tumor progress,quality of life,coagulation function and survival rate of the treatment of middle and late stage lung cancer by Invigorating qi,activating blood and removing stasis method combined with chemotherapy were objectively evaluated to explore the effect of Invigorating qi,activating blood and removing stasis method in the treatment of middle and late stage lung cancer,so as to provide reference for the treatment of middle and late stage lung cancer by traditional Chinese medicine.Methods: The combination of computer retrieval and artificial screening,retrieval of CNKI,VIP,Wanfang,PubMed,MEDLINE and other databases,related to the clinical randomized controlled trial of Invigorating qi,activating blood and removing stasis method combined with chemotherapy in the treatment of advanced lung cancer.According to the inclusion and exclusion criteria,two researchers independently searched the literature,selected the literature,extracted the qualified data in the literature,and cross checked.The total effective rate of clinical short-term efficacy,Tumor progression rate,Improvement efficiency of TCM symptom score,Quality of life score,Coagulation function,Survival rate and other related indicators were used as outcome measurement indicators.Revman 5.3 software was used for meta analysis.Sensitivity analysis and publication bias analysis were carried out to evaluate the stability and reliability of the results.Results: A total of 22 randomized controlled trials were included,including 1705 patients,including 859 in the experimental group and 846 in the chemotherapy group.The results of meta analysis showed that: 1.The short-term efficacy of Invigorating qi,activating blood and removing stasis method combined with chemotherapy in the treatment of middle and advanced lung cancer: according to the WHO standard for the evaluation of the objective efficacy of anti-tumor drugs: the combined effect RR = 0.80,95% CI =(0.71,0.89),the difference between the experimental group and the control group was statistically significant(z = 4.10,P < 0.0001),indicating the short-term efficacy of the experimental group(WHO standard)According to the RECIST standard,RR = 0.74,95% CI =(0.62,0.87),the difference between the experimental group and the control group is statistically significant(z = 3.51,P = 0.005),indicating that the experimental group is better than the control group in the near-term efficacy(RECIST standard).2.Comparison of tumor progression rate of middle and late stage lung cancer treated by Invigorating qi,activating blood and removing stasis method combined with chemotherapy: according to WHO standard: RR = 1.18,95% CI =(1.10,1.26),the difference between the experimental group and the control group is statistically significant(z = 4.63,P < 0.00001),indicating that the experimental group is superior to the control group in Tumor progression rate(WHO standard);according to RECIST standard: RR = 1.18,95 %CI =(1.08,1.28),the difference between the experimental group and the control group was statistically significant(z = 3.84,P = 0.0001),indicating that the experimental group was superior to the control group in tumor progression rate(RECIST standard).3.The comparison of the improvement efficiency of TCM symptom score in the treatment of middle and late stage lung cancer by the method of Invigorating qi,activating blood and removing stasis combined with chemotherapy: RR = 0.39,95% CI =(0.25,0.60).The difference between the experimental group and the control group is statistically significant(z = 4.33,P < 0.0001),indicating that the experimental group is better than the control group in the improvement efficiency of TCM symptom score.4.The comparison of the effective rate of Invigorating qi,activating blood and removing stasis method combined with chemotherapy in the treatment of middle and late stage lung cancer to improve the quality of life of KPS: RR = 0.74,95% CI =(0.65,0.85),the difference between the experimental group and the control group is statistically significant(z = 4.43,P < 0.00001),which shows that the experimental group is better than the control group in improving the quality of life of KPS;Invigorating qi,activating blood and removing stasis method combined with chemotherapy in the treatment of middle and late stage lung cancer K Comparison of PS quality of life score: WMD = 6.71,95% CI =(4.44,8.99).The difference between the experimental group and the control group was statistically significant(z = 5.78,P < 0.00001),indicating that the experimental group was better than the control group in improving KPS quality of life score.5.comparison of the influence of the method of Invigorating Qi and activating blood circulation and removing blood stasis combined with chemotherapy on the coagulation related indexes in the middle and advanced stage of lung cancer:(1)prothrombin time(PT): WMD=-0.15,95%CI=(-0.34,0.05),the difference between the experimental group and the control group was not statistically significant(Z=1.49,P=0.14),indicating that the effect of the experimental group on the prothrombin time(PT)was not different from that of the control group.(2)Partial prothrombin time(APTT): WMD = 0.52,95% CI =(-0.52,1.56).There was no significant difference between the experimental group and the control group(z = 0.97,P = 0.33),indicating that the effect of the experimental group on partial prothrombin time(APTT)was not different from that of the control group.(3)Platelet count(PLT): MWD =-24.97,95% CI =(-41.08,-8.85).Compared with the control group,the difference was statistically significant(z = 3.04,P = 0.002),indicating that the effect of the test group on platelet count(PLT)was different from that of the control group.(4)FIB: WMD =-1.37,95% CI =(-2.17,-0.58).The difference between the experimental group and the control group was statistically significant(z = 3.38,P = 0.0007),indicating that the experimental group was better than the control group in improving fib.(5)D-Dimer(DD): SMD =-0.53,95% CI =(-0.89,0.17).The difference between the experimental group and the control group was statistically significant(z = 2.87,P = 0.004).The results showed that the experimental group was better than the control group in improving D-Dimer(DD).Conclusion: 1.Invigorating qi,activating blood and removing stasis method combined with chemotherapy in the treatment of middle and late stage lung cancer has more advantages than chemotherapy alone in terms of total effective rate,tumor progression rate,improvement rate of TCM symptom score,improvement rate of KPS quality of life and so on;in terms of coagulation function indexes(PLT,FIB and DD),it may have advantages over chemotherapy alone,because of less literature included in the study and publication bias The reliability of the results needs further study.2.At present,the quality of clinical trials on the treatment of middle and late stage lung cancer with Invigorating qi,activating blood and removing stasis method combined with chemotherapy is low,and the overall sample size is small,which results in the lower evidence intensity of its application in the treatment of middle and late stage lung cancer,to a certain extent,affects the authenticity and reliability of meta analysis results.Therefore,the generalization of the conclusions of this study may be limited.