[1]张兵兵,史晓林,吴连国,等.中药预防膝关节置换术后深静脉血栓形成的网状Meta分析[J].中医正骨,2021,33(06):27-35.
 ZHANG Bingbing,SHI Xiaolin,WU Lianguo,et al.Traditional Chinese Medicine therapy for prevention of deep vein thrombosis after the surgery of knee replacement:a network meta-analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(06):27-35.
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中药预防膝关节置换术后深静脉血栓形成的网状Meta分析()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期数:
2021年06期
页码:
27-35
栏目:
文献研究
出版日期:
2021-06-20

文章信息/Info

Title:
Traditional Chinese Medicine therapy for prevention of deep vein thrombosis after the surgery of knee replacement:a network meta-analysis
作者:
张兵兵1史晓林1吴连国1俞兴2孙永生3
1.浙江中医药大学附属第二医院,浙江 杭州 310005; 2.北京中医药大学东直门医院,北京 100700; 3.中国中医科学院望京医院,北京 100102
Author(s):
ZHANG Bingbing1 SHI Xiaolin1WU Lianguo1YU Xing2SUN Yongsheng3
1.The Second Affiliated Hospital of Zhejiang Chinese Medical University,Hangzhou 310005,Zhejiang,China 2.Dongzhimen Hospital of Beijing University of Chinese Medicine,Beijing 100700,China 3.Wangjing Hospital of CACMS,Beijing 100102,China
关键词:
关节成形术置换 静脉血栓形成 中药疗法 网状Meta分析
Keywords:
arthroplastyreplacementknee venous thrombosis drug therapy(TCD) Network meta-analysis
摘要:
目的:系统评价中药预防膝关节置换术后深静脉血栓形成(deep vein thrombosis,DVT)的临床疗效。方法:应用计算机检索中国知网、万方数据库、维普网、Medline、Cochrane library、Embase、Web of Science,搜集应用中药预防膝关节置换术后DVT的随机对照试验,检索时限均为建库至2020年10月1日。经过文献筛选、数据提取及质量评价后,采用Stata14.0软件进行统计分析。结果:共检索到3748篇相关文献,最终纳入59篇,涉及常规西医疗法(《中国骨科大手术静脉血栓栓塞症预防指南》推荐的预防措施)、补气方药联合常规西医疗法、补气方药、补益气血方药、补益气血方药联合常规西医疗法、补肝肾方药联合常规西医疗法及补肝肾方药共7种干预措施。网状Meta分析结果显示,补气方药联合常规西医疗法、补益气血方药联合常规西医疗法及补肝肾方药联合常规西医疗法预防膝关节置换术后DVT的效果均优于常规西医疗法[RR=0.31,95%CI(0.23,0.43); RR=0.27,95%CI(0.10,0.72); RR=0.31,95%CI(0.14,0.71)]; 其余各种干预措施预防膝关节置换术后DVT效果的组间差异均无统计学意义。59项研究中的7种干预措施预防膝关节术后DVT效果的累积概率排序图下面积(surface under the cumulative ranking,SUCRA)排序为补益气血方药联合常规西医疗法(SUCRA=84.3%)>补气方药联合常规西医疗法(SUCRA=81.5%)>补肝肾方药联合常规西医疗法(SUCRA=79.7%)>补气方药(SUCRA=34.1%)>补肝肾方药(SUCRA=33.6%)>补益气血方药(SUCRA=21.7%)>常规西医疗法(SUCRA=15.1%)。结论:目前临床中预防膝关节置换术后DVT的常用方药包括补气方药、补益气血方药及补肝肾方药,临床应用时常联合常规西医疗法; 补气方药联合常规西医疗法、补益气血方药联合常规西医疗法及补肝肾方药联合常规西医疗法预防膝关节置换术后DVT的效果均优于常规西医疗法,其中补益气血方药联合常规西医疗法的预防效果最佳。
Abstract:
Objective:To systematically review the clinical curative effects of Traditional Chinese Medicine(TCM)therapy in preventing deep vein thrombosis(DVT)after the surgery of knee replacement(KR).Methods:All the randomized controlled trial(RCT)articles about TCM therapy for prevention of DVT after KR surgery included from database establishing to October 1,2020 were retrieved from the China National Knowledge Internet,Wanfang Data Knowledge Service Platform,Vip Database,Medline,Cochrane library,Embase and Web of Science through computer.The articles were screened and the information was extracted independently by two researcher.The methodological quality of research in the articles was evaluated and a network meta-analysis was conducted by using Stata14.0 software.Results:Three thousand seven hundred and forty-eight articles were searched out.After screening,59 articles were included in the final analysis,involving conventional western medicine(WM)therapy recommended by Chinese Guidelines for Prevention of Venous Thromboembolism in Major Orthopedic Surgery,Qi-tonics prescriptions combined with conventional WM therapy,Qi-tonics prescriptions,Qi-blood-tonics prescriptions,Qi-blood-tonics prescriptions combined with conventional WM therapy,liver-kidney-tonics prescriptions combined with conventional WM therapy and liver-kidney-tonics prescriptions.The results of network meta-analysis revealed that the efficacies of Qi-tonics prescriptions combined with conventional WM therapy,Qi-blood-tonics prescriptions combined with conventional WM therapy and liver-kidney-tonics prescriptions combined with conventional WM therapy aimed at preventing DVT after KR surgery were better in contrast to conventional WM therapy(RR=0.31,95%CI(0.23,0.43); RR=0.27,95%CI(0.10,0.72); RR=0.31,95%CI(0.14,0.71)); While no statistical differences in the efficacies of the others in preventing DVT after KR surgery were found between the 2 groups.In the 59 RCTs,the efficacies of the 7 interventions for preventing DVT after KR surgery were ranked from best to worst in accordance with surface under the cumulative ranking(SUCRA)values,and the results of SUCRA ranking revealed that Qi-blood-tonics prescriptions combined with conventional WM therapy(SUCRA=84.3%)behaved best in preventing DVT after KR surgery,followed by Qi-tonics prescriptions combined with conventional WM therapy(SUCRA=81.5%),liver-kidney-tonics prescriptions combined with conventional WM therapy(SUCRA=79.7%),Qi-tonics prescriptions(SUCRA=34.1%),liver-kidney-tonics prescriptions(SUCRA=33.6%),Qi-blood-tonics prescriptions(SUCRA=21.7%)and conventional WM therapy(SUCRA=15.1%).Conclusion:The present prescriptions commonly used for preventing DVT after KR surgery in clinic include Qi-tonics prescriptions,Qi-blood-tonics prescriptions and liver-kidney-tonics prescriptions,which are often applied in combination with conventional WM therapy in clinic.The effects of Qi-tonics prescriptions combined with conventional WM therapy,Qi-blood-tonics prescriptions combined with conventional WM therapy and liver-kidney-tonics prescriptions combined with conventional WM therapy in preventing DVT after KR surgery were better in contrast to conventional WM therapy,among which Qi-blood-tonics prescriptions combined with conventional WM therapy behaves best.

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备注/Memo

备注/Memo:
基金项目:浙江省中医药优秀青年人才基金项目(2021ZQ047)
通讯作者:孙永生 E-mail:sunyongshengd@126.com
更新日期/Last Update: 2021-12-20