Abstract: Background　Non-small-cell lung cancer（NSCLC） is a common lethal malignancy that places great stress and burden on society and patients.Chinese medicine injection（CMI） combined with paclitaxel and cisplatin chemotherapy has been widely used in the treatment of NSCLC，and has made great progress in synergistic and attenuating，but there is still a lack of direct or indirect comparison between proprietary Chinese medicines.Objective　To systematically evaluate the efficacy and safety of CMI-assisted paclitaxel and cisplatin chemotherapy in the treatment of NSCLC.Methods　The PubMed，Cochrane Library，CNKI，CBM，Wanfang Data Knowledge Service Platform and VIP databases were searched from inception to March 2019 for RCTs about paclitaxel and cisplatin chemotherapy assisted by 8 kinds of CMIs commonly used in clinical practice（Brucea Javanica Oil Emulsion Injection，Aidi Injection，Matrine Injection，Cinobufacini Injection，Delisheng Injection，Xiaoaiping Injection，Kang'ai Injection，Shenqi Fuzheng Injection） in the treatment of NSCLC.Quality evaluation and data extraction were performed on the included RCTs.Mesh analysis was performed using the GeMTC and Stata 14.Results　Finally，10 RCTs and 49 semi-RCTs were included.Network meta-analysis showed that by directly comparing，the case groups treated with either of 5 CMIs（Aidi Injection，Matrine Injection，Xiaoaiping Injection，Kang'ai Injection，and Shenqi Fuzheng Injection） showed better short-term efficacy than the controls（P<0.05）.Moreover，the case groups treated with either of 8 CMIs demonstrated lower incidence of leukopenia（P<0.05）.By indirectly comparing，the case groups treated with either of the CMIs except Brucea Javanica Oil Emulsion Injection and Xiaoaiping Injection showed lower incidence of nausea and vomiting（P<0.05）.And the quality of life impaired by chemotherapy improved more significantly in all CMI-treated groups（P<0.05）.In terms of the probability of improving the short-term effect of chemotherapy，Cinobufacini Injection had highest probability，followed by Xiaoaiping Injection，Kang'ai Injection，Aidi Injection，Shenqi Fuzheng Injection，Matrine Injection，Delisheng Injection，and Brucea Javanica Oil Emulsion Injection.In terms of reducing the possibility of developing chemotherapy-induced leucopenia，Cinobufacini Injection also showed highest probability，followed by Xiaoaiping Injection，Shenqi Fuzheng Injection，Delisheng Injection，Aidi Injection，Brucea Javanica Oil Emulsion Injection，Matrine Injection，and Kang'ai Injection.With regards to reducing the possibility of developing chemotherapy-induced nausea and vomiting，Shenqi Fuzheng Injection demonstrated highest possibility，followed by Delisheng Injection，Xiaoaiping Injection，Cinobufacini Injection，Matrine Injection，Brucea Javanica Oil Emulsion Injection，Kang'ai Injection，and Aidi Injection.In respect of the possibility of improving health-related quality of life impaired by chemotherapy，Kang'ai Injection showed highest possibility，followed by Brucea Javanica Oil Emulsion Injection，Xiaoaiping Injection，Delisheng Injection，Cinobufacini Injection，Aidi Injection，Shenqi Fuzheng Injection，and Matrine Injection.Conclusion　This analysis shows that，in enhancing the clinical effect of anticancer，Cinobufacini Injection and Kang'ai Injection are more effective；Shenqi Fuzheng Injection and Cinobufacini Injection show better effects on reducing the toxic side effects of chemotherapy.And Cinobufacini Injection is recommended as the first choice for adjuvant therapy for paclitaxel and cisplatin chemotherapy for NSCLC for all concerned.

Key words: Carcinoma, non-small cell lung；Clinical efficacy；Traditional Chinese medicine injection；Network meta-analysis；Treatment outcome

摘要： 背景　非小细胞肺癌（NSCLC）是一种常见的致死性恶性肿瘤，给社会和患者造成了极大压力和负担。中药注射剂（CMI）联合紫杉醇和顺铂化疗方案被广泛应用于NSCLC的治疗，并在增效减毒方面取得了较大的进展，但目前还缺少中药之间直接或间接比较。目的　系统评价CMI联合紫杉醇和顺铂化疗方案治疗NSCLC的有效性和安全性。方法　计算机检索PubMed、Cochrane Library、中国知网（CNKI）、中国生物医学文献数据库（CBM）、万方知识服务平台和维普网（VIP），检索时限为建库至2019年3月，搜集有关临床常用的8种CMI（鸦胆子油乳注射液、艾迪注射液、苦参注射液、华蟾素注射液、得力生注射液、消癌平注射液、康艾注射液、参芪扶正注射液）联合紫杉醇和顺铂化疗方案治疗NSCLC的随机对照试验（RCT）研究。对纳入研究进行质量评价和数据提取，用软件gemtc和Stata 14做网状Meta分析。结果　最终纳入10个RCT、49个半RCT。网状Meta分析结果显示：8种CMI与对照组近期疗效间直接比较，艾迪注射液、苦参注射液、消癌平注射液、康艾注射液、参芪扶正注射液效果优于对照组（P<0.05）。8种CMI与对照组出现白细胞计数减少间直接比较，效果均优于对照组（P<0.05）；8种CMI之间间接比较，参芪扶正注射液优于苦参注射液（P<0.05）。8种CMI与对照组出现恶心呕吐症状间直接比较，艾迪注射液、苦参注射液、华蟾素注射液、得力生注射液、康艾注射液、参芪扶正注射液效果优于对照组（P<0.05）。8种CMI与对照组提高化疗生活质量间直接比较，效果均优于对照组（P<0.05）。提高化疗近期疗效的概率：华蟾素注射液>消癌平注射液>康艾注射液>艾迪注射液>参芪扶正注射液>苦参注射液>得力生注射液>鸦胆子油乳注射液；降低白细胞计数减少发生的概率：华蟾素注射液>消癌平注射液>参芪扶正注射液>得力生注射液>艾迪注射液>鸦胆子油乳注射液>苦参注射液>康艾注射液；减少化疗引起恶心呕吐症状发生的概率：参芪扶正注射液>得力生注射液>消癌平注射液>华蟾素注射液>苦参注射液>鸦胆子油乳注射液>康艾注射液>艾迪注射液；改善化疗生活质量的概率：康艾注射液>鸦胆子油乳注射液>消癌平注射液>得力生注射液>华蟾素注射液>艾迪注射液>参芪扶正注射液>苦参注射液。结论　综合网状Meta所纳入各项结果分析和测量指标排序结果，在增强抗癌临床效果方面，华蟾素注射液和康艾注射液较其他6种CMI相对有效；在降低毒副作用方面，参芪扶正注射液和华蟾素注射液较其他6种CMI相对有效；综合各项指标，联合紫杉醇和顺铂化疗方案治疗NSCLC时，可优先考虑华蟾素注射液。

关键词: 癌, 非小细胞肺；中药注射剂；临床疗效；网状Meta分析；治疗结果