目的 通過系統(tǒng)評價(jià)的方法評價(jià)補(bǔ)益類中藥對腫瘤患者放射性肺炎的治療作用。方法 檢索Pubmed、Cochrane Library、Embase、中國期刊全文數(shù)據(jù)庫（CNKI）、維普中文科技期刊全文數(shù)據(jù)庫（VIP）、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫（CBM）、萬方數(shù)據(jù)庫等中英文數(shù)據(jù)庫，檢索時(shí)間從建庫至2017年9月1日。用Revman 5.0軟件對納入研究進(jìn)行方法學(xué)質(zhì)量評價(jià)，用Stata 12.0對主要指標(biāo)放射性肺炎的療效，輔助指標(biāo)包括影像學(xué)改變、糖皮質(zhì)激素使用時(shí)間、生活質(zhì)量、免疫功能、肺功能以及細(xì)胞因子水平等進(jìn)行分析。結(jié)果 共納入47項(xiàng)研究，共3 071例患者。與對照組相比，使用補(bǔ)益藥能有效治療放射性肺炎[OR=3.778，95% CI（3.098，4.609），P=0.000]，提高患者的生活質(zhì)量[OR=3.509，95% CI（2.655，4.638），P=0.000]，減少激素使用時(shí)間[WMD=-6.313，95% CI（-9.349，-3.276），P=0.000]，改善患者用力呼氣量與用力肺活量的比值，降低轉(zhuǎn)化生長因子-β（TGF-β）水平；但對肺活量（VC）、第1秒用力呼氣量（FEV1）、免疫功能的改善作用不明顯。亞組分析及回歸分析顯示治療效果與使用補(bǔ)益藥的種類、是否聯(lián)合使用激素、用藥總時(shí)長以及患者的腫瘤類型無關(guān)。結(jié)論 補(bǔ)益類中藥可使放射性肺炎患者的癥狀及影像學(xué)檢查均得到改善，并能改善患者的生活質(zhì)量，減少激素的使用時(shí)間。

Objective To evaluate the therapeutic effect of tonic traditional Chinese medicine on radiation pneumonitis by means of Meta-analysis. Methods Pubmed, Cochrane Library, Embase, CNKI, VIP, CBM, and Wanfang were retrieved online from their inception to September 1, 2017. Revman 5.0 software was used to assess the bias of the included studies, and Stata 12.0 was used to evaluate the extraction of the therapeutic effects of radiation pneumonitis. Auxiliary indicators include imaging changes, the use time of glucocorticoid, the quality of life, immune function, lung function, and cytokine levels. Results A total of 47 studies involving 3071 patients were included, and methodological quality has moderate bias. Compared with the control group, Chinese tonic medicine can be effective in the treatment of radiation pneumonitis[OR=3.778,95% CI(3.098,4.609), P=0.000], improve the quality of life[OR=3.509, 95% CI(2.655,4.638), P=0.000], reduce the glucocorticoid use time[WMD=-6.313, 95% CI(-9.349,-3.276), P=0.000], improve the level of FEV1/VC, and reduce the level of transforming growth factor-β (TGF-β). But for vital capacity (VC), the improvement of forced expiratory volume in one second (FEV1) and immune function is not obvious. Subgroup analysis and regression analysis showed that the effects of treatment were not related to the type of tonic drugs used, whether they were used in combination with glucocorticoid, the total duration of the medication, and the type of tumor of the patient. Conclusion Chinese tonic medicine can improve the symptoms and pulmonary imaging of patients who have radiation pneumonitis, improve the quality of life, and reduce the use time of glucocorticoid.

遼寧省科技廳"產(chǎn)業(yè)共性技術(shù)創(chuàng)新平臺"資助項(xiàng)目（2014226033）