来源：风湿病与关节炎,2019,8（8）:36-40.

中医外治法对髌骨软骨软化症患者干预效果Meta分析

和试验序贯分析（循证研究）

孔　亮¹，李　薏¹，邢伟鹏²，向兴彤¹，杨　鑫²，李俊雄³，曹向阳²

　　【摘　要】目的：系统评价中医外治法对髌骨软骨软化症患者的干预效果。方法：计算机检索Pubmed、Cochrane Library、Embase、中国生物医学文摘数据库、中国知网、万方、维普等数据库。在采用中医外治疗法对髌骨软骨软化症患者且Jadad评分≥2分的随机对照试验中，2名研究者分别筛选文献并严格评价纳入研究质量以及数据提取。Meta分析采用Revman v5.3版本，试验序贯分析（TSA）采用v0.9.5版本。结果：最终纳入9篇随机对照文献，共618例患者。Meta分析结果显示，与西医常规保守疗法相比，采用中医外治疗法的治疗组在总治愈率和总有效率方面更优（Z = 6.39，P < 0.01）；TSA结果显示，传统中医外治法的总治愈率和总有效率的累计Z值均穿过了传统和TSA界值，间接提高了Meta分析结论的信度。结论：与西医常规保守治疗比较，采用中医外治法治疗髌骨软骨软化症疗效更显著。

　　【关键词】　髌骨软骨软化症；中医外治法；分析；试验序贯分析

Meta-analysis and TSA of Intervention Effect of TCM External Treatment on Patients with Patellar Chondromalacia

KONG Liang,LI Yi,XING Wei-peng,XIANG Xing-tong,YANG Xin,LI Jun-xiong,CAO Xiang-yang

　　【ABSTRACT】Objective:To systematically evaluate the intervention effect of TCM（traditional Chinese medicine）external treatment on patients with patellar chondromalacia.Methods:Data bases such as Pubmed,Cochrane Library,Embase,CBM,CNKI,Wanfang,and VIP were retrieved by computer.In randomized controlled trials for patients with chondromalacia patellae externally treated with Chinese medicine,those whose Jadad score was no less than two were screened by two researchers and strictly evaluated for study quality and data extraction.Revman v5.3 was used for meta-analysis and v0.9.5 for trial sequential analysis（TSA）.Results:Nine randomized controlled trails were included,618 patients altogether.Meta-analysis showed that the total cure rate and total effective rate of TCM external treatment for the treatment group were better than the conventional conservative treatment（Z = 6.39,P < 0.01）.The results of TSA showed that the aggregate-value Z of the total cure rate and total effective rate of TCM treatment passed the traditional and TSA critical values,which indirectly improves the reliability of Meta-analysis results.Conclusion:Compared with the conventional conservative treatment of Western medicine,the TCM external treatment for patellar chondromalacia is more effective.

　　【Keywords】 chondromalacia patellae;TCM external treatment;Meta-analysis;trial sequential analysis