Objective: To systematically evaluate the efficacy and explore the mechanisms of Yiqi and blood-activating traditional Chinese medicine (TCM) combined with chemotherapy in treating non-small cell lung cancer (NSCLC). Methods: Randomized controlled trials (RCTs) on chemotherapy combined with Yiqi and blood-activating TCM for NSCLC were retrieved from CNKI, VIP, Wanfang, and PubMed databases. The search period covered from the inception of each database to January 2025. Study quality was assessed via the Cochrane Risk of Bias tool. Meta-analysis evaluated clinical efficacy, data mining identified core herbs and active compounds, and network pharmacology analyzed targets and pathways. Immune infiltration analysis explored immunomodulatory mechanisms. Results: A total of 57 RCTs with 4865 patients were analyzed. Combined therapy significantly improved short-term efficacy, relieved symptoms (e.g., cough, fatigue), reduced adverse effects, and enhanced quality of life versus chemotherapy alone. Data mining identified Astragalus membranaceus, Atractylodes macrocephala, and Poria cocos as core herbs. Network pharmacology revealed 40 active compounds (including quercetin and kaempferol) that targeted 137 key proteins (e.g., TP53, AKT1), with these targets mainly involved in immune regulation. Immune infiltration analysis showed increased CD4+ T cells and balanced T cell subsets, indicating enhanced antitumor immunity. Conclusions: Yiqi and blood-activating TCM combined with chemotherapy improves NSCLC outcomes by modulating the tumor immune microenvironment. This supports the integration of TCM and highlights immune regulation as a key mechanism.
Xu et al. (2025) studied this question.