中药外敷方案治疗癌性腹水疗效的Meta分析

Therapeutic Effect of External Application of Traditional Chinese Medicine in Treatment of Malignant Ascites:A Meta-analysis

目的系统评价中药外敷方案治疗癌性腹水的疗效。方法计算机检索Cochrane数据库、Pubmed、中国知网、万方医学网、维普数据库、中国生物医学文献数据库，纳入运用中药外敷方案治疗癌性腹水的临床随机对照试验（检索时间为建库至2015年10月），运用RevMan5．1软件进行Meta分析。结果共纳入17篇文献，共879例。中药外敷治疗组腹水显效率显著高于对照组（Z=5．48，P〈0．05；OR值=2．32，OR值的95％CI为1.72～3．14）；中药外敷组KPs评分改善率显著高于对照组（Z=4．78，P〈0．05；OR值=4．27，OR值的95％CI为2．35～7．74），KPS评分显著高于对照组（Z=19．29，P〈0．05；均数差为10．88，均数差的95％CI为9．77～11．98），中药外敷后患者偶有皮疹、瘙痒等皮肤过敏反应，无血常规、肝功能和肾功能异常。结论中药外敷方案对于消除癌性腹水，改善患者生活质量具有一定的疗效且安全性好。

Objective To investigate the therapeutic effect of external application of traditional Chinese medicine （TCM） in the treatment of malignant ascites through a systemic review. Methods The Cochrane Library, PubMed, CNKI, Wanfang Data, VIP, and CMB were searched for randomized controlled trials （RCTs） about external application of TCM in the treatment of malignant ascites published up to October 2015, and RevMan 5.1 was used to perform the meta-analysis. Results A total of 17 RCTs were included, with 879 patients in total. The TCM external application group had a significantly higher marked response rate than the control group （Z=5.48, P〈0. 05; OR=2. 32, 95% CI 1.72-3.14）. Compared with the control group, the TCM external application group showed a significantly higher rate of improvement in Karnofsky Performance Scale （KPS） score （Z：4. 78, P〈0.05; OR = 4. 27, 95% CI 2.35-7.74） and a significantly higher KPS score （Z=19. 29,P〈0. 05;MD=10. 88,95% CI 9. 77-11.98）. After external ap- plication of TCM,the patients occasionally experienced skin allergies such as rash and pruritus. There were no abnormalities in routine blood test results, liver function, or renal function. Conclusion External appli- cation of TCM can eliminate malignant ascites and improve patients＇ quality of life and has good safety.