目的 系統(tǒng)評(píng)價(jià)黃芪注射液聯(lián)合放化療對(duì)癌癥患者療效和免疫功能的影響，為臨床使用提供循證醫(yī)學(xué)的相關(guān)參考。方法 計(jì)算機(jī)檢索中國(guó)期刊全文數(shù)據(jù)庫(kù)（CNKI）、萬(wàn)方數(shù)據(jù)庫(kù)（Wanfang Deta）、中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù)（CBM）、維普生物醫(yī)學(xué)數(shù)據(jù)庫(kù)（VIP）、PubMed、Cochrane圖書(shū)館等數(shù)據(jù)庫(kù)中有關(guān)黃芪注射液聯(lián)合放化療治療癌癥的隨機(jī)對(duì)照臨床試驗(yàn)（RCT），檢索時(shí)間為各數(shù)據(jù)庫(kù)建庫(kù)起至2021年11月1日。使用Cochrane工具評(píng)價(jià)文獻(xiàn)質(zhì)量，用RevMan 5.3軟件進(jìn)行Meta分析。結(jié)果 共納入16項(xiàng)RCTs，1 340例患者。Meta分析結(jié)果顯示：黃芪注射液在輔助癌癥的放化療治療中能顯著提高治療有效率［RR=1.96，95% CI（1.53，2.50）］，提高患者CD₃⁺［MD=7.47，95% CI（5.05，9.90）］、CD₄⁺［MD=4.96，95% CI （3.84，6.09） ］、CD₈⁺ ［MD=7.47，95% CI （5.05，9.90） ］水平、CD₄⁺/CD₈⁺的值［MD=0.29，95% CI （0.20，0.14）］，有效改善患者生存質(zhì)量［RR=11.48，95% CI=（10.44，12.51）］，改善放化療引起的口干、黏膜損傷、皮炎損傷等不良反應(yīng)發(fā)生率，與對(duì)照組比較差異均具有顯著意義（P＜0.000 01）。結(jié)論 黃芪注射液協(xié)同放化療治療癌癥可以提高治療有效率、改善患者生活質(zhì)量、促進(jìn)患者免疫功能、降低不良反應(yīng)，鑒于研究局限性，尚需更多高質(zhì)量、大樣本RCTs進(jìn)一步驗(yàn)證。

Objective To systematically evaluate the effects of Astragalus Injection combined with radiotherapy and chemotherapy on the efficacy and immune function of cancer patients, and to provide evidence-based medicine reference for clinical use. Methods Data were electronically searched from CNKI, Wanfang Deta, CBM, VIP, PubMed, Cochrane Library to collet randomized controlled trails (RCTs) on Astragalus Injection combined with radiotherapy and chemotherapy in the treatment of cancer from the establishment of each database to November 1, 2021. Cochrane tools were used to evaluate the literature quality and RevMan 5.3 software was used for Meta-analysis. Results A total of 16 RCTs involving 1 340 patients were included. Meta-analysis showed that the use of Astragalus Injection in adjuvant chemoradiotherapy for cancer significantly increased the effective rate [RR = 1.96, 95%CI (1.53, 2.50)], and increased CD₃⁺[MD = 7.47, 95%CI (5.05, 9.90)], CD₄⁺ [MD = 4.96, 95%CI (3.84, 6.09)], CD₈⁺ [MD = 7.47,95%CI (5.05, 9.90)], CD₄⁺/CD₈⁺ [MD = 0.29, 95%CI (0.20, 0.14)], can effectively improve the quality of life [RR = 11.48, 95%CI (10.44, 12.51)], and has significant significance compared with the control group (P<0.000 01). It can improve the incidence of dry mouth, mucous membrane injury, dermatitis injury and other toxic and side effects caused by radiotherapy and chemotherapy, and has significant significance compared with the control group (P<0.000 01). Conclusion Astragalus Injection combined with radiotherapy and chemotherapy in the treatment of cancer can improve the effective rate of treatment, improve the quality of life of patients, promote the immune function of patients, and reduce adverse reactions. In view of the limitations of the study, more highquality, large-sample RCTs are needed for further verification.

R979.1

國(guó)家自然科學(xué)基金青年基金資助項(xiàng)目(81703921);天津市醫(yī)學(xué)重點(diǎn)建設(shè)學(xué)科資助項(xiàng)目(津衛(wèi)科教［2021］492號(hào));天津中醫(yī)藥大學(xué)中西醫(yī)結(jié)合學(xué)院2019年度研究生創(chuàng)新基金(ZXYCXLX201911)