来源：风湿病与关节炎,2018,7（10）:25-30.

中药外用治疗骨关节炎的Meta分析（循证研究）

易国祥^1,2，魏良纲¹，李延萍¹，吴　斌¹

　　【摘　要】目的：系统评价中药外用治疗骨关节炎的疗效与安全性。方法：计算机检索中国知网（CNKI）、万方（WANFANG DATA）、维普（VIP）等数据库2013年1月至2018年1月发表的中药外用（治疗组）与扶他林（对照组）治疗骨关节炎的随机对照试验，对纳入文献采用Cochrane Library提供的风险偏倚评估工具评价后，用Cochrane协作网提供的Review Manager 5.3软件进行Meta分析。结果：最终纳入17个研究，共1994例患者，其中治疗组1003例，对照组991例。疗效评价指标包括疗效等级、VAS评分、Lequesne评分、WOMAC评分、HSS评分、Lysholm评分。Meta 分析发现，中药外用总有效率优于扶他林（OR = 6.18，95%CI = ［4.49，8.49］；Z = 11.21，P < 0.000 01）；VAS评分治疗组疼痛改善更明显（MD = 1.15，95%CI = ［0.46，1.85］；Z = 3.25，P = 0.001）；治疗组WOMAC评分优势显著（MD = 4.12，95%CI = ［3.46，4.79］；Z = 12.22，P < 0.000 1）。结论：中药外用治疗骨关节炎优于扶他林外用，但因纳入文献质量偏低，存在实验设计等诸多问题，尚需更多高质量文献来确定疗效。

　　【关键词】　骨关节炎；中药；外用；Meta分析

Meta-analysis of Treating Osteoarthritis by External Application of Chinese Medicine

YI Guo-xiang,WEI Liang-gang,LI Yan-ping,WU Bin

 　　【ABSTRACT】Objective:To systematically evaluate the efficacy and safety of external application of Chinese medicine in the treatment of osteoarthritis.Methods:Randomized controlled trials on the treatment of osteoarthritis by external application of Chinese medicine（the treatment group）or fostalin（the control group）published from January 2013 to January 2018 in databases such as CNKI,WANFANG DATA and VIP were retrieved by computer.Risk bias assessments were made for the included literature by the evaluation tool provided by Cochrane Library.A meta-analysis was carried out with software Review Manager 5.3 provided by Cochrane Collaboration.Results:A total of 1994 patients were enrolled in 17 studies,including 1003 patients in the treatment group and 991 patients in the control group.The evaluation index of curative effect includes curative effect grade,VAS score,Lequesne score,WOMAC score,HSS score and Lysholm score.Meta-analysis showed that the total effective rate of external use of Chinese medicine was better than that of fostalin（OR = 6.18,95%CI = ［4.49,8.49］;Z = 11.21,P < 0.000 01）;VAS score showed that the improvement of pain in the treatment group was more significant（MD = 1.15,95%CI = ［0.46,1.85］;Z = 3.25,P = 0.001）;WOMAC score in the treatment group was significant（MD = 4.12,95%CI = ［3.46,4.79］;Z = 12.22,P < 0.000 1）.Conclusion:The external application of Chinese medicine is better than fostalin in the treatment of osteoarthritis.However,due to the low quality of literature and the problems of experimental design,more high quality literature is needed to determine the efficacy.

　　【Keywords】 osteoarthritis;Chinese medicine;external application;Meta-analysis