中药熏洗治疗膝关节骨性关节炎的Meta分析

为运用循证医学方法对中药熏洗治疗膝骨性关节炎（OA）的临床疗效及安全性进行系统评价和Meta分析。全面收集了中药熏洗治疗OA的文献资料。在严格质量评价基础上，对研究结果进行定性分析。合并各篇优、良为阳性结果，中、差为阴性结果。利用RevMan4．1软件对多个研究结果的总体疗效进行固定效应模型的Meta分析，并进行敏感性分析。用漏斗图表示发表性偏倚。结果显示，中药熏洗治疗OA的效应值OR=2．68.95％可信区间为1．82，3．95]；敏感性分析显示效应值稳定；漏斗图图形不对称；无中药熏洗不良反应的报道。表明中药熏洗治疗OA有一定的疗效，由于漏斗图提示存在发表性偏倚，加上现有临床研究存在的方法学问题，现在的研究结论有一定的局限性，欲得出公认的结论，尚有待进行设计严谨的多中心、随机对照试验。

META ANALYSIS OF STEAMING AND WASHING OF CHINESE MEDICINE IN TREATMENT OSTEOARTHRITIS OF KNEE

In order to Meta analyze and evaluate with Evidence-Based Medicine the clinical effect and security of steaming and washing of Chinese medicine (SWCM, a TCM therapeutic way for disease) in the treatment of osteoarthritis of knee(OA), the related OA papers were reviewed roundly, the content and quality evaluated systematically and strictly. The positive was the all good and excellent cases while the negative was the all so-so and bad cases, the total effect of those OA papers was sensibility and Meta (fixed effect pattern) analyzed by RevMan4.1 statistical soft, systematic error indicated by funnellike chart. The results showed that the effect value of SWCM treating OA was OR=2.68, the 95% credibility interval was from 1.82 to 3.95, the OR value was steady according to sensilitical analysis, there was unsymmetrical manifestation in funnellike chart, and there no bad reaction was reported in the reviewed papers, suggesting that SWCM has some function to treat OA of knee ,but it need to make further study with polycentric, random and contrapositive trial for the systematic bias and limitation in methodology for research.