来源：风湿病与关节炎,2020,9（6）:27-31.

中药贴膏治疗膝骨关节炎疗效的Meta分析（循证研究）

蔡　鑫¹，唐　芳²，马武开²，兰维娅²，蒋　总¹，樊　梅¹，金泽旭¹

　　【摘　要】目的：系统评价中药贴膏治疗膝骨关节炎的疗效及安全性。方法：计算机检索中国知网（CNKI）、万方（Wanfang）、维普（VIP）、中国生物医学文献数据库（CBM）及PubMed等数据库中单独使用中药贴膏治疗膝骨关节炎的临床随机对照试验（RCT）文献，根据Cochrane系统评价手册，采用Rev Man 5.3软件进行分析。结果：通过筛选最终纳入9篇文献，共纳入776例患者，试验组389例，对照组387例。Meta分析结果表明，单独使用中药贴膏外敷治疗膝骨关节炎在总有效率（OR = 3.36，95%CI = ［1.96，5.75］，P < 0.000 1）、视觉模拟评分法（VAS）评分（SMD = -1.78，95%CI = ［-2.58，-0.98］，P < 0.000 1）、西安大略和麦克马斯特大学骨关节炎评分（WOMAC评分）（SMD = -1.29，95%CI = ［-2.44，-0.15］，P = 0.03）等方面均明显优于对照组，但在中医证候积分（SMD = -1.23，95%CI = ［-3.06，-0.60］，P = 0.19）、不良反应（OR = 0.66，95%CI = ［0.23，1.87］，P = 0.44）方面比较，差异无统计学意义。结论：单独运用中药贴膏治疗膝骨关节炎在总有效率、VAS评分、WOMAC评分等方面疗效更优，在中医证候积分、不良反应方面2组效果相当；由于所纳入的研究样本量较小，且文献质量有限，故尚需采用更大样本量和更高质量的研究评估中药贴膏治疗膝骨关节炎的优势。

　　【关键词】　骨关节炎，膝；中药贴膏；随机对照试验；Meta分析

Meta-analysis of Therapeutic Effect of TCM Paste on Knee Osteoarthritis

CAI Xin,TANG Fang,MA Wu-kai,LAN Wei-ya,JIANG Zong,FAN Mei,JIN Ze-xu

　　【ABSTRACT】Objective:To systematically evaluate the efficacy and safety of TCM paste in the treatment of knee osteoarthritis.Methods:RCT articles on the treatment of osteoarthritis with TCM paste only were retrieved from the databases as CNKI,Wanfang,VIP,CBM and PubMed,and Rev Man 5.3 was used to analyze the collected data.Results:Nine articles were retrieved,including 776 patients,389 experimental group and 387 control group.The results of meta-analysis showed that the total effective rate（OR = 3.36,95% CI = ［1.96,5.75］,P < 0.000 1）,VAS score（SMD = -1.78,95% CI = ［-2.58,-0.98］,P < 0.0001）,WOMAC score（SMD = -1.29,95% CI= ［-2.44,-0.15］,P = 0.03）in the treatment group with TCM paste only were significantly better than those in the control group,but there was no significant difference in TCM syndrome score（SMD = -1.23,95% CI = ［-3.06,-0.60］,P = 0.19）and adverse reactions（OR = 0.66,95% CI =［0.23,1.87］,P = 0.44）.Conclusion:The curative effect of TCM paste on knee osteoarthritis is better in total effective rate,VAS score,and WOMAC score.The two groups have the same effect in TCM syndrome score and adverse reactions.However,it is necessary to use a larger amount of samples with higher quality to evaluate the effect of TCM paste on knee osteoarthritis.

　　【Keywords】 osteoarthritis,knee;TCM paste;randomized controlled trial;Meta-analysis