中医外治疗法辅助治疗肺癌患者化疗所致恶心呕吐的Meta分析

Meta-Analysis of Adjuvant Treatment of Chemotherapy-Induced Nausea and Vomiting in Lung Cancer Patients with Traditional Chinese Medicine External Therapies

摘要: 目的：系统评价中医外治疗法辅助治疗肺癌患者化疗所致恶心呕吐的有效性。方法：通过中国知网、万方、维普、传统医学研究数据库扩展集、PubMed、Web of Science、the Cochrane Library检索中医外治疗法辅助治疗肺癌患者化疗所致恶心呕吐的临床研究，检索时间限制在建库至2025年8月1日。使用Review Manager5.4软件进行异质性检验和统计分析。结果：共纳入14项研究，共989例患者。Meta分析结果显示，中医外治疗法辅助治疗肺癌化疗所致恶心呕吐，能提高治疗有效率[RR = 1.21, 95% CI (1.12, 1.31), P < 0.0001]。虽能提高KPS功能状态量表评分[MD = 5.14, 95% CI (−4.63, 14.92), P = 0.30]，但差异无统计学意义。降低SAS焦虑评分[MD = −5.90, 95% CI (−6.15, −5.65), P < 0.00001]，减轻血清前白蛋白的减少程度[MD = 6.41, 95% CI (1.88, 10.94), P = 0.006]。结论：中医外治疗法能较好地提高肺癌患者化疗所致恶心呕吐的有效率，改善患者焦虑情况，减轻血清前白蛋白的下降程度，但对于改善KPS评分的证据不足，总体疗效较好，有一定推广意义。

Abstract: Objective: To systematically evaluate the effectiveness of external Traditional Chinese Medicine (TCM)therapies as an adjuvant treatment for chemotherapy-induced nausea and vomiting (CINV)in lung cancer patients. Methods: Clinical studies on external TCM therapies adjuvant to conventional treatment for CINV in lung cancer patients were retrieved from databases including CNKI, Wanfang, VIP, TMRDE, PubMed, Web of Science and the Cochrane Library. The search period spanned from the inception of each database to August 1, 2025. Heterogeneity testing and statistical analysis were performed using Review Manager5.4 software. Results: A total of 14 studies involving 989 patients were included. Meta-analysis results showed that: External TCM therapies significantly improved the effective treatment rate for CINV [RR = 1.21, 95% CI (1.12, 1.31), P < 0.00001]. Although they increased the KPS score [MD = 5.14, 95% CI (−4.63, 14.92), P = 0.30], the difference was not statistically significant. They significantly reduced the SAS score [MD = −5.90, 95% CI (−6.15, −5.65), P < 0.00001], alleviated the reduction in serum prealbumin (PA) levels [MD = 6.41, 95% CI (1.88, 10.94), P = 0.006].Conclusions: External TCM therapies can effectively improve the treatment response rate for CINV in lung cancer patients, alleviate anxiety, and attenuate the decline in PA levels. Nevertheless, evidence for improving KPS scores remains insufficient. These therapies are generally effective and worthy of clinical.