中药外治慢性前列腺炎的系统评价

Systemic review of external treatment of Chinese medicines for chronic prostatitis

目的系统评价中药外治法治疗慢性前列腺炎（CP）的疗效和不良反应，以期指导临床决策。方法采用循证医学的方法，全面检索国内1979年1月至2010年12月之间中医药治疗CP的临床研究文献，依据JADAD量表和试验分配的隐藏方案评价文献的质量。对纳入的文献进行Meta分析，用Revman5．0软件进行统计和系统评价。结果中药外治法治疗慢性前列腺炎比西医治疗方法（内服或外用药物）更加有效（P〈0．00001）；比物理治疗（微波，坐浴）更加有效（P=0．001）；与中药内治法比较差异无统计学意义（P=0．11）。4篇文献报道了不良反应，包括肛门不适、下坠感、便意感、轻度腹泻和敷贴过敏。结论应该进行大规模、多中心、随机对照的临床试验，并以客观指标为疗效评价标准来研究中药外治法治疗慢性前列腺炎的效果，并评价药物不良反应。

Objective To evaluate the effects of external treatment of Chinese medicines on chronic prostatitisand guide its clinical application. Methods All the studies about external treatment of Chinese medicines for chronic prostatitis from January 1979 to December 2010 were retrieved based on the methods of evidence-based medicine （EBM）, and their qualities were evaluated based on JADAD standard and concealment of research allocation. The included studies were analyzed by META-analysis using Revman 5.0 software. Results The efficacy of external treatment of Chinese medicines for chronic prostatitis was better than that of western medicines（internal or external use） （P〈0.00001）, and that of physical treatment （P=0.001） However, no significance difference was found in efficacy between external treatment of Chinese medicines and internal treatment of chinese medicine （P=0.11）. Side effects of these external treatment of Chinese medicines including upset and bearing down of anus, desire of defecate, mild diarrhea and allergic to plaster were reported in four studies. Conclusion Massive, multi-center and randomized controlled clinical trials should be carried out for evaluating the effects of external treatment of Chinese medicine on chronic prostatitis by objective indexes t and its side effects.