数字中医药（英文）2025，Vol.8Issue(1)：59-75,17.DOI:10.1016/j.dcmed.2025.03.006
中药外敷联合三阶梯镇痛药物治疗癌性骨痛:一项系统评价和meta分析
External application of traditional Chinese medicine in combination with three-step analgesic ladder therapy for cancer-induced bone pain:a systematic review and meta-analysis
摘要
Abstract
Objective To systematically evaluate the overall efficacy of external application of traditional Chinese medicine(EA-TCM)in combination with oral three-step analgesic ladder therapy for patients suffering from cancer-induced bone pain(CIBP). Methods We conducted a literature search of randomized controlled trials on the combina-tion of EA-TCM and three-step analgesic ladder therapy for CIBP across ten databases and two registration systems.It included four Chinese databases[Chinese Biomedical Literature Database(SinoMed),China National Knowledge Infrastructure(CNKI),Wanfang Database,and China Science and Technology Journal Database(VIP)],six English databases(Scopus,Embase,Web of Science,PubMed,Cochrane Library,and OpenGrey),and two registration systems(Chinese Clinical Trial Registry and ClinicalTrials.gov).The timeframe for the litera-ture search extended from the inception of each database to December 31,2023.Meta-analy-sis was performed using RevMan(v5.4.1),and the outcome indicators(pain relief rate,anal-gesic duration,quality of life,pain intensity,breakthrough pain frequency,and adverse reac-tions)were graded using GRADE profiler(v3.6). Results According to the established inclusion and exclusion criteria,a total of 43 studies was deemed eligible,involving 3 142 participants with CIBP.The results of meta-analysis showed that compared with oral three-step analgesic ladder therapy alone,the combined therapy of EA-TCM and three-step analgesic ladder has a significant improvement in pain relief rate[risk ratio(RR)=1.32,95%confidence interval(CI):1.24 to 1.41,P＜0.000 01],analgesic dura-tion[mean difference(MD)=1.33,95%CI:0.97 to 1.69,P＜0.000 01],and quality of life(MD=5.66,95%CI:4.88 to 6.44,P＜0.000 01).Furthermore,the combined therapy significantly re-duced pain intensity(MD=-1.00,95%CI:-1.19 to-0.80,P＜0.000 01),breakthrough pain frequency(MD=-0.43,95%CI:-0.51 to-0.36,P＜0.000 01),and adverse reactions(RR=0.60,95%CI:0.53 to 0.68,P＜0.000 01)in CIBP patients.Based on the GRADE assessment,the level of evidence varied from low to moderate. Conclusion EA-TCM combined with the three-step analgesic ladder therapy can effectively alleviate pain symptoms in patients with CIBP and improve their quality of life.Additionally,the EA-TCM can effectively reduce the incidence of adverse reactions associated with three-step analgesic therapy.关键词
中药外敷/三阶梯镇痛药物/癌性骨痛/系统评价/meta分析Key words
External application of traditional Chi-nese medicine(EA-TCM)/Three-step analgesic ladder therapy/Cancer-induced bone pain(CIBP)/Systematic review/Meta-analysis引用本文复制引用
王菲,赖桂花,周芳,聂多锐,程雄涛,王岳,曹建雄..中药外敷联合三阶梯镇痛药物治疗癌性骨痛:一项系统评价和meta分析[J].数字中医药（英文）,2025,8(1):59-75,17.基金项目
Provincial Key Research and Development Project of Hu-nan(2018SK2127),and Hunan Province Traditional Chi-nese Medicine Research and Development Project(201946). （2018SK2127）
