[1]卢泽声,蔡惟楚,李昌繁,等.术后应用不同中药复方口服对手术治疗足踝骨折疗效影响的网状Meta分析[J].中医正骨,2025,37(05):42-57.
　LU Zesheng,CAI Weichu,LI Changfan,et al.Effects of oral application of different Chinese herbal compounds following the surgery on the efficacy of surgical treatment of foot and ankle fractures:a network meta-analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2025,37(05):42-57.
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术后应用不同中药复方口服对手术治疗足踝骨折疗效影响的网状Meta分析()

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第37卷
期数:
2025年05期
页码:
42-57
栏目:
文献研究
出版日期:
2025-05-20

文章信息/Info

Title:
Effects of oral application of different Chinese herbal compounds following the surgery on the efficacy of surgical treatment of foot and ankle fractures:a network meta-analysis
作者:
卢泽声1; 蔡惟楚1; 李昌繁1; 陈铄鑫1; 施训清2; 高怡加3
1.广州中医药大学第一临床医学院,广东 广州 510405; 2.广州中医药大学茂名医院,广东 茂名 525000; 3.广州中医药大学第一附属医院,广东 广州 510405
Author(s):
LU Zesheng1; CAI Weichu1; LI Changfan1; CHEN Shuoxin1; SHI Xunqing2; GAO Yijia3
1.The First Clinical Medical College of Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong,China 2.Maoming Hospital of Guangzhou University of Chinese Medicine,Maoming 525000,Guangdong,China 3.The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong,China
关键词:
踝部骨折;  踝关节;  跟骨;  Pilon骨折;  治疗结果;  复方(中药);  手术后期间;  网络Meta分析
Keywords:
ankle fractures;  ankle joint;  calcaneus;  Pilon fractures;  treatment outcome;  compounds(TCD);  postoperative period;  network Meta-analysis
摘要:
目的:系统评价术后应用不同中药复方口服对手术治疗足踝骨折疗效的影响。方法:应用计算机检索中国知网、万方数据库、中国生物医学文献服务系统中关于足踝骨折术后应用中药复方口服治疗的对比研究文献,检索时限均为2011年1月1日至2024年9月29日。试验组术后采用中药复方口服联合西医常规治疗,对照组采用西医常规治疗。依据文献检索及筛选方案筛选出符合要求的文献后,由2名研究人员分别独立进行数据提取和质量评价。采用Stata14.2软件对足踝部疼痛视觉模拟量表(visual analogue scale,VAS)评分、美国足与踝关节协会(American Orthopaedic Foot and Ankle Society,AOFAS)踝与后足评分、血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平、血清白细胞介素(interleukin,IL)-6水平、临床总有效率、并发症发生率进行网状Meta分析,并根据累计概率排名曲线下面积(the surface under the cumulative ranking curve,SUCRA)进行排序。采用漏斗图检验发表偏倚。结果:共检索到5006项研究,最终纳入75项研究。在改善足踝部疼痛VAS评分方面,不同中药复方的疗效排序为牛膝活血汤口服+西医常规治疗(SUCRA=95.9%)>舒筋活血汤口服+西医常规治疗(SUCRA=70.0%)>强筋活血复元汤口服+西医常规治疗(SUCRA=62.6%)>桃红四物汤口服+西医常规治疗(SUCRA=50.5%)>桃红四物汤合用五苓散口服+西医常规治疗(SUCRA=40.5%)>活血接骨汤口服+西医常规治疗(SUCRA=28.2%)>西医常规治疗(SUCRA=2.3%); 在改善AOFAS踝与后足评分方面,不同中药复方的疗效排序为复元活血汤口服+西医常规治疗(SUCRA=98.3%)>舒筋活血汤口服+西医常规治疗(SUCRA=70.4%)>桃红四物汤口服+西医常规治疗(SUCRA=44.0%)>七厘散口服+西医常规治疗(SUCRA=34.2%)>西医常规治疗(SUCRA=3.2%); 在改善血清TNF-α水平方面,不同中药复方的疗效排序为活血化瘀汤口服+西医常规治疗(SUCRA=96.5%)>舒筋活血汤口服+西医常规治疗(SUCRA=60.8%)>七厘散口服+西医常规治疗(SUCRA=45.1%)>牛膝活血汤口服+西医常规治疗(SUCRA=42.0%)>西医常规治疗(SUCRA=5.6%); 在改善血清IL-6水平方面,不同中药复方的疗效排序为活血化瘀汤口服+西医常规治疗(SUCRA=93.5%)>七厘散口服+西医常规治疗(SUCRA=74.8%)>舒筋活血汤口服+西医常规治疗(SUCRA=44.5%)>活血镇痛汤口服+西医常规治疗(SUCRA=44.4%)>续骨活血汤口服+西医常规治疗(SUCRA=39.7%); 在临床总有效率方面,不同中药复方的疗效排序为补阳还五汤口服+西医常规治疗(SUCRA=84.8%)>舒筋活血汤口服+西医常规治疗(SUCRA=63.9%)>牛膝活血汤口服+西医常规治疗(SUCRA=56.3%)>复元活血汤口服+西医常规治疗(SUCRA=51.0%)>桃红四物汤口服+西医常规治疗(SUCRA=43.9%)>西医常规治疗(SUCRA=0.0%); 在降低并发症发生率方面,不同中药复方的排序为续骨活血汤口服+西医常规治疗(SUCRA=76.7%)>活血化瘀汤口服+西医常规治疗(SUCRA=74.3%)>舒筋活血汤口服+西医常规治疗(SUCRA=53.2%)>一盘珠汤口服+西医常规治疗(SUCRA=53.1%)>桃红四物汤口服+西医常规治疗(SUCRA=42.0%)>西医常规治疗(SUCRA=0.7%)。结论:足踝骨折术后在西医常规疗法基础上应用不同中药复方,均能够促进术后康复,其中牛膝活血汤在缓解疼痛方面更具优势,复元活血汤在改善踝关节功能方面更具优势,活血化瘀汤在控制炎症方面更具优势,补阳还五汤在提高临床总有效率方面更具优势,续骨活血汤在降低并发症发生率方面更具优势。
Abstract:
Objective:To systematically review the effects of oral application of different Chinese herbal compounds(CHCs)following the surgery on the efficacy of surgical treatment of foot and ankle fractures.Methods:All the comparative study articles about oral application of CHCs following the surgery for foot and ankle fractures included from January 1,2011 to September 29,2024 were retrieved from the China National Knowledge Infrastructure,Wanfang Database and Chinese Biomedical Literature Service System through computer.The patients in experiment group were treated with oral application of CHCs combined with conventional western medicine(WM)treatment after the surgery,while the ones in control group with conventional WM treatment alone.The eligible articles were screened according to the retrieval and screening scheme.The information was extracted and the methodological quality of the included researches in the articles was evaluated independently by two researchers.After that,the reticulated plots were drawn by using Stata14.2 software,and a reticulated Meta-analysis of foot and ankle pain visual analogue scale(VAS)score,American Orthopaedic Foot and Ankle Society(AOFAS)ankle-hind score,serum tumor necrosis factor-α(TNF-α)level,serum interleukin(IL)-6 level,total clinical effective rate,and complication incidence was conducted,furthermore,the adopted treatment methods were ranked according to the surface under the cumulative ranking curve(SUCRA),and the publication bias was tested by using a comparison-correction funnel plot.Results:Five thousand and six articles were searched out.After screening,75 articles were included in the final analysis.The reticulated Meta-analysis revealed that,oral application of Niuxi Huoxue Tang(牛膝活血汤,NXHXT)combined with conventional WM treatment(SUCRA=95.9%)exhibited greater superiority in improving the foot and ankle pain VAS score,followed by oral application of Shujin Huoxue Tang(舒筋活血汤,SJHXT)combined with conventional WM treatment(SUCRA=70.0%),oral application of Qiangjin Huoxue Fuyuan Tang(强筋活血复元汤,QJHXFYT)combined with conventional WM treatment(SUCRA=62.6%),oral application of Taohong Siwu Tang(桃红四物汤,THSWT)combined with conventional WM treatment(SUCRA=50.5%),oral application of THSWT and Wuling San(五苓散,WLS)combined with conventional WM treatment(SUCRA=40.5%),oral application of Huoxue Jiegu Tang(活血接骨汤,HXJGT)combined with conventional WM treatment(SUCRA=28.2%),and conventional WM treatment alone(SUCRA=2.3%); the oral application of Fuyuan Huoxue Tang(复元活血汤,FYHXT)combined with conventional WM treatment(SUCRA=98.3%)behaved best in improving the AOFAS ankle-hind score,followed by oral application of SJHXT combined with conventional WM treatment(SUCRA=70.4%),oral application of THSWT combined with conventional WM treatment(SUCRA=44.0%),oral application of Qili San(七厘散,QLS)combined with conventional WM treatment(SUCRA=34.2%),and conventional WM treatment alone(SUCRA=3.2%); the oral application of Huoxue Huayu Tang(活血化瘀汤,HXHYT)combined with conventional WM treatment(SUCRA=96.5%)acted best in improving serum level of TNF-α,followed by oral application of SJHXT combined with conventional WM treatment(SUCRA=60.8%),oral application of QLS combined with conventional WM treatment(SUCRA=45.1%),oral application of NXHXT combined with conventional WM treatment(SUCRA=42.0%),and conventional WM treatment alone(SUCRA=5.6%); the oral application of HXHYT combined with conventional WM treatment(SUCRA=93.5%)acted best in improving serum level of IL-6,followed by oral application of QLS combined with conventional WM treatment(SUCRA=74.8%),oral application of SJHXT combined with conventional WM treatment(SUCRA=44.5%),oral application of Huoxue Zhentong Tang(活血镇痛汤,HXZTT)combined with conventional WM treatment(SUCRA=44.4%),and oral application of Xugu Huoxue Tang(续骨活血汤,XGHXT)combined with conventional WM treatment(SUCRA=39.7%); the oral application of Buyang Huanwu Tang(补阳还五汤,BYHWT)combined with conventional WM treatment(SUCRA=84.8%)performed best in the total clinical effective rate,followed by oral application of SJHXT combined with conventional WM treatment(SUCRA=63.9%),oral application of NXHXT combined with conventional WM treatment(SUCRA=56.3%),oral application of FYHXT combined with conventional WM treatment(SUCRA=51.0%),oral application of THSWT combined with conventional WM treatment(SUCRA=43.9%),and conventional WM treatment alone(SUCRA=0.0%); the oral application of XGHXT combined with conventional WM treatment(SUCRA=76.7%)excelled in reducing the incidence of complications,followed by oral application of HXHYT combined with conventional WM treatment(SUCRA=74.3%),oral application of SJHXT combined with conventional WM treatment(SUCRA=53.2%),oral application of Yipanzhu Tang(一盘珠汤)combined with conventional WM treatment(SUCRA=53.1%),oral application of THSWT combined with conventional WM treatment(SUCRA=42.0%),and conventional WM treatment alone(SUCRA=0.7%).Conclusion:Application of different CHCs on the basis of conventional WM therapies following the surgery for foot and ankle fractures can promote postoperative rehabilitation.Among the CHCs,the NXHXT exhibits greater superiority in relieving the pain,the FYHXT behaves best in improving the ankle joint function,the HXHYT acts best in controlling the inflammation,the BYHWT performs best in enhancing the total clinical effective rate,and the XGHXT excels in reducing the incidence of complications.

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备注/Memo

备注/Memo:
基金项目:全国名老中医药专家传承工作室建设项目(国中医药人教函〔2022〕75号)
通讯作者:高怡加 E-mail:gaoyijia99@163.com
更新日期/Last Update: 1900-01-01