中药外敷治疗恶性胸腔积液有效性和安全性的Meta分析

doi:10.13481/j.1671-587X.20260520

Abstract

Abstract:

Objective To systematically evaluate the clinical efficacy and safety of external application of traditional Chinese medicine in the treatment of malignant pleural effusion （MPE）， and to provide evidence-based support for clinical application. Methods The databases including CNKI， VIP， Wanfang Data， Chinese Biology Medicine， PubMed， Embase， Cochrane Library， and Web of Science were searched to retrieve the studies of randomized controlled trials （RCTs） on external application of traditional Chinese medicine for MPE published from inception to March 18， 2026. The patients were divided into experimental group （receiving external application of traditional Chinese medicine alone or as an adjunct to conventional Western medical treatment） and control group （receiving conventional Western medical treatment alone or placebo external application）. RevMan 5.4 and R 4.3.3 softwares were used to conduct the meta-analysis. The outcome measures included pleural effusion response rate， Karnofsky performance status （KPS） score， KPS score improvement rate， and incidence of adverse reactions. This systematic review was prospectively registered in PROSPERO （registration number： CRD420251178277）. Results A total of 25 RCTs involving 1 616 patients were included. The meta-analysis results showed that compared with control group， the pleural effusion response rate of the patients in experimental group was significantly increased ［risk ratio （RR）=1.30， 95% confidence interval （CI）： 1.22-1.40， P<0.000 1］， the KPS score was significantly increased ［mean difference （MD）=9.28， 95%CI： 6.79-12.76， P<0.000 1］， and the KPS score improvement rate was significantly increased （RR=1.42， 95%CI： 1.15-1.74， P=0.000 9）. For safety outcomes， compared with control group， the incidences of gastrointestinal reactions （RR=0.65， 95%CI： 0.51-0.82， P=0.000 3）， leukopenia （RR=0.56， 95%CI： 0.33-0.93， P=0.03）， and chest pain （RR=0.80， 95%CI： 0.67-0.97， P=0.02） of the patients in experimental group were significantly decreased， while the incidence of local skin reactions was significantly increased （RR=8.38， 95%CI： 2.58-27.15， P=0.000 4）. Conclusion External application of traditional Chinese medicine， as an adjunctive treatment， shows potential value in improving the pleural effusion response rate and functional status in the patients with MPE， but skin adverse reactions should be closely monitored.

Key words: External application of traditional Chinese medicine, Malignant pleural effusion, Meta-analysis, Systematic evaluation, Randomized controlled trial

CLC Number:

R273

Geer A,Qin WANG,Lijing JIAO,Yabin GONG. Meta-analysis of efficacy and safety of traditional Chinese medicine external therapy in treating malignant pleural effusion[J].Journal of Jilin University(Medicine Edition), 2026, 52(5): 1390-1407.

Figures/Tables 26

Fig. 1

Tab.1

Basic characteristics of included studies"

Study	Samplesize		Age（year）		Intervention		Duration	Outcome	Assessment timeof pleural effusionresponse
Study	E	C	E	C	E	C	Duration	Outcome	Assessment timeof pleural effusionresponse
LAN，et al.2019^[5]	30	30	50.12±12.48	52.14±11.56	External application of TCM+pleural drainage+intrapleural CDDP	Pleural drainage+intrapleural CDDP	15 d	①②④	30 days after treatment
WU，et al.2006^[6]	38	36	65±3	63±4	External application of TCM+conventional treatment	Conventionaltreatment	2 months	①	2 months after treatment
LUO，et al.2014^[7]	24	20	61.2±5.1	59.6±7.8	External application of TCM+pleural drainage+intrapleural CDDP	Pleural drainage+intrapleural CDDP	28 d	①④	4 weeks after treatment
HUANG，et al.2012^[8]	30	30	33-75	36-71	External application of TCM+pleural drainage+intrapleural CDDP	Pleural drainage+intrapleural CDDP	3 weeks	①④	1 month after treatment
YANG，et al. 2021^[9]	30	30	63.16±2.85	72.86±3.01	External application of TCM+pleural drainage+intrapleural CDDP	Pleural drainage+intrapleural CDDP	4 weeks	①②④	4 weeks after treatment
YANG，et al. 2017^[10]	24	24	63.26±2.38	64.86±2.38	External application of TCM+pleural drainage+intrapleural CDDP	Pleural drainage+intrapleural CDDP	4 weeks	①	4 weeks after treatment
LIU，et al. 2014^[11]	25	25	51±13	53±15	External application of TCM+pleural drainage+intrapleural CDDP	Pleural drainage+intrapleural CDDP	15 d	①④	1 month after treatment
LI，et al.2016^[12]	30	30	38-70	40-70	External application of TCM+pleural drainage+intrapleural elemene	Pleural drainage+intrapleural elemene	2 weeks	①④	4 weeks after treatment
LI，et al.2018^[13]	22	22	-	-	External application of TCM+pleural drainage+intrapleural CDDP	Pleural drainage+intrapleural CDDP	4 weeks	①④	4 weeks after treatment
HE，et al.2015^[14]	30	30	-	-	External application of TCM+pleural drainage+intrapleural CDDP+hyperthermia	Pleural drainage+intrapleural CDDP+hyperthermia	4 weeks	①③④	4 weeks after treatment
DIAO，et al.2011^[15]	36	34	65±3	63±4	External application of TCM+pleural drainage+intrapleural CDDP	Pleural drainage+intrapleural CDDP	2 months	①④	30 days after treatment
KAO，et al.2017^[16]	25	25	57.5±4.2	56.3±4.7	External application of TCM+pleural drainage+intrapleural CDDP	Pleural drainage+intrapleural CDDP	14 d	②	-
HUO，et al.2013^[17]	25	25	35-75	36-78	External application of TCM+pleural drainage+intrapleural CDDP	Pleural drainage+intrapleural CDDP	4 weeks	①③④	4 weeks after treatment
LEI，et al.2012^[18]	32	32	35-70	38-69	External application of TCM+pleural drainage+intrapleural BLM+IL-2	Pleural drainage+intrapleural BLM+IL-2	28 d	①③④	4 weeks after treatment
LUO，et al.2025^[19]	40	20	58.53±6.71	58.44±6.83	External application of TCM+pleural drainage	Pleural drainage	2 weeks	①②④	2 weeks after treatment
LIU，et al.2019^[20]	60	60	61.18±3.32	61.15± 3.28	External application of TCM+pleural drainage+intrapleural CDDP	Pleural drainage+intrapleural CDDP	4 weeks	①	4 weeks after treatment
XIONG，et al.2019^[21]	33	33	-	-	External application of TCM+intrapleural CDDP	Intrapleural CDDP	4 weeks	①④	4 weeks after treatment
YU，et al.2023^[22]	33	32	56.8±6.9	58.2±7.5	External application of TCM+pleural drainage+intrapleural CDDP	Pleural drainage+intrapleural CDDP	8 weeks	①②	4 weeks after treatment
SHAN，et al.2024^[23]	45	45	65.47±11.28	63.26±10.25	External application of TCM+pleural drainage+intrapleural CDDP	Pleural drainage + intrapleural CDDP	4 weeks	①③	4 weeks after treatment
HU，et al.2023^[24]	30	30	52.33±9.12	52.18±8.55	External application of TCM+pleural drainage+intrapleural CDDP+5-FU hyperthermic perfusion	Pleural drainage+intrapleural CDDP+5-FU hyperthermic perfusion	2 weeks	①②④	1 month after treatment
JIA，et al.2002^[25]	25	25	35-75	37-73	External application of TCM	Pleural drainage+intrapleural IFN	4 weeks	①③	1 month after treatment
WANG，et al.2018^[26]	30	30	50(39-66)	49(40-62)	External application of TCM+pleural drainage+intrapleural recombinant human adenovirus type 5	Pleural drainage+intrapleural recombinant human adenovirus type 5	10 d	①	4 weeks after treatment
WU，et al.2017^[27]	33	32	-	-	External application of TCM	Placebo external application	2 weeks	①②④	Immediateafter treatment
ZHANG，et al.2021^[28]	42	42	63.7(41-80)	62.5 (38-79)	External application of TCM+pleural drainage+intrapleural CDDP	Pleural drainage+intrapleural CDDP	28 d	①	4 weeks after treatment
TIAN，et al.2019^[29]	52	50	55(31-72)	53(33-70)	External application of TCM+pleural drainage+intrapleural IL-2	Pleural drainage+intrapleural IL-2	2 weeks	①④	4 weeks after treatment

Tab.1

Fig. 2

Fig. 3

Fig. 4

Fig. 5

Fig. 6

Fig. 7

Fig. 8

Fig. 9

Fig. 10

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Fig. 12

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Fig. 15

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Fig. 17

Fig. 18

Tab.2

Fig. 19

Fig. 20

Fig. 21

Fig. 22

Fig. 23

Fig. 24

References 35

[1]	BIBBY A C， DORN P， PSALLIDAS I， et al. ERS/EACTS statement on the management of malignant pleural effusions［J］. Eur J Cardiothorac Surg， 2019， 55（1）： 116-132.
[2]	中国恶性胸腔积液诊断与治疗专家共识组. 恶性胸腔积液诊断与治疗专家共识［J］. 中华内科杂志， 2014， 53（3）： 252-256.
[3]	阿格尔，焦丽静，周海伦，等. 中医药治疗恶性胸腔积液的思考和实践［J］. 内蒙古医科大学学报， 2024， 46（1）： 32-35.
[4]	袁逸帆，朱睿，龚亚斌，等. 苓桂术甘汤加减内服联合消水贴外敷治疗肺癌合并胸腔积液的临床研究［J］. 上海中医药杂志， 2022， 56（2）： 45-48.
[5]	蓝轶. 自拟中药方剂外敷治疗恶性胸腔积液临床疗效观察［J］. 临床合理用药杂志， 2019， 12（25）： 45-46.
[6]	吴孝田. 中药油膏外敷辅佐治疗恶性胸腔积液38例［J］. 陕西中医， 2006， 27（5）： 546-547.
[7]	罗银星，张影，蔡小平. 中药穴位贴敷联合顺铂胸腔灌注治疗恶性胸腔积液随机平行对照研究［J］. 实用中医内科杂志， 2014， 28（7）： 97-99.
[8]	黄琼. 中药外敷联合胸腔内化疗治疗肺癌恶性胸腔积液30例［J］. 浙江中医杂志， 2012， 47（2）： 102.
[9]	杨胜利，赵家亮. 中药外敷联合顺铂胸腔注射治疗肺癌合并癌性胸水患者临床疗效及对生活质量的影响［J］. 湖北中医杂志， 2021， 43（10）： 23-27.
[10]	杨胜利，颜昭君，赵家亮. 中药外敷联合顺铂胸腔注射治疗癌性胸水临床观察［J］. 湖北中医杂志， 2017， 39（6）： 35-36.
[11]	刘匡飞，刘昆，张晶，等. 中药外敷联合顺铂胸腔灌注治疗恶性胸腔积液临床观察［J］. 中国药业， 2014， 23（6）： 71-72.
[12]	黎壮伟，邓力，周海平. 中药外敷联合榄香烯注射液胸腔灌注治疗恶性胸腔积液的临床研究［J］. 湖北中医杂志， 2016， 38（8）： 10-11.
[13]	李思旋，唐洪屈，夏徐，等. 中药外敷辅治非小细胞肺癌胸水临床研究［J］. 实用中医药杂志， 2018， 34（11）： 1355-1356.
[14]	何宁一，洪月光. 中西医结合三位一体治疗恶性胸腔积液疗效观察［J］. 四川中医， 2015， 33（5）： 96-97.
[15]	刁哲欣，胡永进，刘进满. 中药悬饮贴膏佐治恶性胸腔积液的疗效观察［J］. 河北医药， 2011， 33（3）： 449-450.
[16]	考重燕. 胸腔灌注化疗联合中药外敷治疗恶性胸腔积液的观察和护理［J］. 中国医药指南， 2017， 15（22）： 28-29.
[17]	霍志刚，武纪生，魏玉芳，等. 消水散外敷改善恶性胸腔积液患者生活质量的临床观察［J］. 环球中医药， 2013， 6（8）： 615-617.
[18]	雷秋娥，熊忠太，黄崇政. 消水扶正膏联合胸腔灌注治疗肺癌恶性胸水64例临床观察［J］. 成都医学院学报， 2012， 7（3S）： 78-79.
[19]	罗苑园，徐倩. 消水Ⅰ号方外敷治疗恶性胸腔积液的临床效果观察［J］. 现代医学与健康研究电子杂志， 2025， 9（16）： 96-99.
[20]	刘宝义. 消积逐水方外敷治疗恶性胸腔积液的临床疗效观察［J］. 中国医药指南， 2019， 17（6）： 162.
[21]	熊绍权，李亚玲，杨扬，等. 温阳逐水方外敷联合顺铂腔内灌注治疗恶性胸水的临床研究［J］. 辽宁中医杂志， 2019， 46（1）： 90-92.
[22]	余旭彪，徐海虹，赵佳丽，等. 温阳通络逐水散穴位贴敷联合顺铂治疗肺癌并发恶性胸腔积液的临床观察及其对VEGF、 HIF-1α的影响［J］. 中国中医药科技， 2023（3）： 488-490.
[23]	单兰，宋芳蕾，陈媛媛. 纳子法指导下金龙硝黄散择时外敷联合胸腔灌注治疗恶性胸腔积液的临床研究［J］. 中华养生保健， 2024， 42（17）： 9-13.
[24]	胡景春，江小锋，陈克秀，等. 芒硝外敷联合体腔热灌注化疗治疗恶性胸腔积液的疗效观察［J］. 现代诊断与治疗， 2023， 34（7）： 986-988.
[25]	贾立群，李佩文，谭煌英，等. 抗癌消水膏治疗恶性胸腔积液的临床研究［J］. 北京中医药大学学报， 2002， 25（4）： 63-65.
[26]	王维，李枋霏，肖彩芝，等. 攻癌利水散外敷联合重组人5型腺病毒注射液胸腔内灌注治疗肺癌恶性胸水的临床疗效［J］. 中国老年学杂志， 2018， 38（21）： 5184-5186.
[27]	WU F Z， LIU M， LOU Y N， et al. A randomized controlled study to observe the efficacy of external treatment with a traditional Chinese medicine herbal ointment on malignant plural effusion： outcome report and design review［J］. Integr Cancer Ther， 2017， 16（4）： 473-478.
[28]	ZHANG H C， JIANG M Y， GAO L R， et al. The clinical efficacy of external application of mirabilite and rhubarb combined with intrathoracic chemotherapy in treating malignant pleural effusion： a prospective， randomized， controlled clinical trial［J］. Medicine， 2021， 100（7）： e24758.
[29]	TIAN A P， YIN Y K， YU L， et al. Low-frequency sonophoresis of Chinese medicine formula improves efficacy of malignant pleural effusion treatment［J］. Chin J Integr Med， 2020， 26（4）： 263-269.
[30]	中国健康促进与教育协会，中国抗癌协会癌症康复与姑息治疗专业委员会. 肺癌合并恶性胸腔积液诊疗专家共识［J］. 中华肿瘤杂志， 2024， 46（1）： 40-47.
[31]	中华医学会呼吸病学分会. 恶性胸腔积液治疗的中国专家共识（2023年版）［J］. 中华结核和呼吸杂志， 2023， 46（12）： 1189-1203.
[32]	周鸿飞，范涛点校. 黄帝内经素问［M］. 郑州：河南科学技术出版社， 2017： 42.
[33]	徐成贺. 金匮要略［M］. 郑州：河南科学技术出版社， 2019： 221-222.
[34]	石岩. 中医内科学［M］. 2版. 北京：科学出版社， 2022： 334.
[35]	杨君，周立江，高宏，等. 中医外治法治疗恶性肿瘤胸腔积液的疗效及安全性系统评价［J］. 天津中医药大学学报， 2018， 37（6）： 483-487.

Adverse reaction	Studies	Heterogeneity	Effect model	RR（95%CI）	P
Gastrointestinal reaction	10	I²=0%, P=0.80	Fixed-effect model	0.65（0.51,0.82）	0.000 3
Leukopenia	6	I²=42%, P=0.13	Random-effect model	0.56（0.33,0.93）	0.03
Chest pain	6	I²=0%， P=0.96	Fixed-effect model	0.80（0.67,0.97）	0.02
Fever	7	I²=0%， P=0.61	Fixed-effect model	0.77（0.59,1.00）	0.05
Skin reactions	6	I²=0%, P=0.97	Fixed-effect model	8.38（2.58,27.15）	0.000 4
Abnormal liver and renal function	2	I²=0%, P=0.89	Fixed-effect model	0.38（0.10,1.35）	0.13

Meta-analysis of efficacy and safety of traditional Chinese medicine external therapy in treating malignant pleural effusion

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