大黄芒硝外敷治疗妇科恶性肿瘤术后盆腔淋巴囊肿的系统评价及GRADE证据质量评价*

作者：赵婷玉1,2，姜文晶1,2，谢 萍2

单位：1.成都中医药大学，四川 成都 610072； 2.成都中医药大学附属医院，四川 成都 610072

引用：引用：赵婷玉，姜文晶，谢萍.大黄芒硝外敷治疗妇科恶性肿瘤术后盆腔淋巴囊肿的系统评价及GRADE证据质量评价[J].中医药导报,2025,31(9):193-198.

DOI：10.13862/j.cn43-1446/r.2025.09.032

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摘要：

目的：系统评价大黄芒硝外敷对妇科恶性肿瘤术后盆腔淋巴囊肿（PL）的有效性及安全性。方法：检索中国知网（CNKI）、万方数据知识服务平台（Wanfang Data）、维普中文期刊服务平台（CSTJ）、中国生物医学文献服务系统（SinoMed）、Cochrane Library、PubMed、Web of Science、Embase数据库中截至2023年12月的相关随机对照试验（RCTs）。使用RevMan 5.4.1软件进行数据分析，采用Cochrane偏倚风险评估工具对文献质量进行评估，并通过GRADE系统对证据质量进行分级。结果：共纳入7项研究，涉及518例患者。Meta分析表明，与西医常规治疗比较，大黄芒硝外敷联合西医常规治疗可显著提高PL的临床疗效[RR=1.23，95%CI（1.14，1.33），P<0.000 01]，缩短引流管置管时间[MD=-2.32，95%CI（-2.42，-2.22），P<0.000 01]，加速囊肿消退[MD=-3.80，95%CI（-5.21，-2.38），P<0.000 01]，并减少盆腔积液量[MD=-56.26，95%CI（-60.55，-51.98），P<0.000 01]，且未观察到明显不良反应[RR=1.84，95%CI（0.86，3.96），P=0.12]。GRADE证据质量评估提示结局指标质量较低。结论：大黄芒硝外敷治疗PL具有一定的临床疗效和安全性，临床可使用大黄芒硝外敷作为辅助治疗方案。

关键词：妇科恶性肿瘤；盆腔淋巴囊肿；大黄；芒硝；外敷；随机对照试验；系统评价

Abstract：

Objective: To systematically evaluate the efficacy and safety of external application of Dahuang (Rhei Radix et Rhizoma) and Mangxiao (Natrii Sulfas) in the treatment of postoperative pelvic lymphocyst (PL) in gynecological malignant tumors. Methods: Randomized controlled trials (RCTs) related to the topic up to December 2023 were retrieved from CNKI, Wanfang Data, CSTJ, SinoMed, Cochrane Library, PubMed, Web of Science, and Embase databases. RevMan 5.4.1 software was used for data analysis, the Cochrane risk of bias assessment tool was applied to evaluate the literature quality, and the GRADE system was used to grade the evidence quality. Results: A total of 7 studies involving 518 patients were included. Meta-analysis showed that compared with conventional western medicine treatment, the combination of external application of Dahuang (Rhei Radix et Rhizoma) and Mangxiao (Natrii Sulfas) with conventional Western medicine treatment could significantly improve the clinical efficacy of PL [RR=1.23, 95% CI (1.14, 1.33), P<0.000 01], shorten the indwelling time of drainage tube [MD=-2.32, 95%CI (-2.42, -2.22), P<0.000 01], accelerate cyst regression [MD=-3.80, 95% CI (-5.21,  -2.38), P<0.000 01], and reduce the amount of pelvic effusion [MD=-56.26, 95%CI (-60.55, -51.98), P<0.000 01], with no obvious adverse reactions observed [RR=1.84, 95% CI (0.86, 3.96), P=0.12]. The GRADE evidence quality assessment indicated that the quality of outcome indicators was low. Conclusion: The external application of Dahuang (Rhei Radix et Rhizoma) and Mangxiao (Natrii Sulfas) has certain clinical efficacy and safety in the treatment of PL, and can be used as an auxiliary treatment option in clinical practice.

Key words：gynecological malignant tumors; pelvic lymphocyst; Dahuang (Rhei Radix et Rhizoma); Mangxiao (Natrii Sulfas); external application; randomized controlled trial; systematic review

发布时间：2026-01-08

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