中医药外用治疗癌痛系统评价

Chinese Herbal Medicine with External Application for Cancer Pain: A Systematic Review

目的:对中医药外用治疗癌性疼痛疗效进行系统评价。方法:以"中药""外治法""癌性疼痛"等为关键词,检索1/1991-10/2013年间Pubmed数据库、Cochrane图书馆、MEDLINE、EMBASE、CBM数据库、万方数据库、维普数据库、中国知网(CNKI)等中英文数据库的相关文献。筛选中医药外治癌痛的随机对照试验文献,按照Cochrane手册提供的系统评价措施对文献进行文献质量评估。结果:最终纳入9篇文献,均未进行恰当的分配隐藏且无随访报道;存在盲法不足、样本量小、具体中药处方报道不详、无中药质控措施、临床相关性不高等弊端,存在"高偏倚风险"。结论:中医药外用治疗疼痛临床研究循证医学证据不足,需加强严格设计、高质量的随机对照试验。

Objective ： To conduct a systematic review of the Chinese herbal medicine with external application for cancer pain. Methods ： A systematic search with reference tracing was conducted that uses Chinese herbal medicine, cancer pain, external application as the keywords,in databases of Pubmed database, Cochrane Library, MEDLINE, EMBASE, CBM database, Wanfang database,VIP database and CNKI database in Chinese and in English from 1/1991 to 10/2013 to determine possible eligible articles. We screened external use Chinese herbal medicine for cancer pain randomized controlled trials, then performed systematic reviews according to the Cochrane Handbook provides quality assessment of the literature. Results ： Nine RCTs were included and they all missed the allocation concealment and follow - up reports. Because of the shortcomings blinding, small sample size, unknown specific medicine prescription coverage, missing medicine quality control, the low clinical relevance, all the trials were evaluated as high risk of bias. Conclusion：Due to the insufficient evidence based medicine of Chinese herbal medicine with external application for cancer pain,there is need for strict designed and high quality RCTs.