[1]谷邦宁,崔崇嵩,何敏聪,等.全髋关节置换术后应用不同中医外治法疗效和安全性的网状Meta分析[J].中医正骨,2025,37(08):15-23.
　GU Bangning,CUI Chongsong,HE Mincong,et al.Clinical efficacy and safety of different Traditional Chinese Medicine external therapies after total hip arthroplasty:a network meta-analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2025,37(08):15-23.
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全髋关节置换术后应用不同中医外治法疗效和安全性的网状Meta分析()

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第37卷
期数:
2025年08期
页码:
15-23
栏目:
文献研究
出版日期:
2025-08-20

文章信息/Info

Title:
Clinical efficacy and safety of different Traditional Chinese Medicine external therapies after total hip arthroplasty:a network meta-analysis
作者:
谷邦宁1; 崔崇嵩2; 何敏聪3; 杨帆3; 魏秋实3; 何伟3
1.广州中医药大学第三临床医学院,广东 广州 510006; 2.广州中医药大学第二临床医学院,广东 广州 510120; 3.广州中医药大学第三附属医院,广东 广州 510378
Author(s):
GU Bangning1; CUI Chongsong2; HE Mincong3; YANG Fan3; WEI Qiushi3; HE Wei3
1.The Third Clinical Medical College of Guangzhou University of Chinese Medicine,Guangzhou 510006,Guangdong,China 2.The Second Clinical Medical College of Guangzhou University of Chinese Medicine,Guangzhou 510120,Guangdong,China 3.The Third Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510378,Guangdong,China
关键词:
关节成形术; 置换; 髋;  手术后期间;  外治疗法;  针刺;  推拿疗法;  耳针疗法;  网络Meta分析
Keywords:
arthroplasty; replacement; hip;  postoperative period;  external treatment;  acupuncture;  Tui Na therapy;  auricular acupuncture therapy;  network Meta-analysis
摘要:
目的:系统评价全髋关节置换术后应用不同中医外治法的疗效和安全性。方法:应用计算机检索中国知网、维普网、万方数据库、中国生物医学文献服务系统、PubMed、Embase、Cochrane Library、Web of Science中在髋关节置换术后应用中医外治法治疗的对比研究文献,检索时限均为建库至2024年7月1日。试验组在术后采用中医外治法联合常规西药治疗,对照组仅采用常规西药治疗。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软件进行网状Meta分析,并根据累积概率排名曲线下面积(the surface under the cumulative ranking curve,SUCRA)对不同中医外治法的疗效和安全性进行排序。结果:共检索到2219篇文献,最终纳入17篇文献。17项研究涉及腕踝针、针刺、耳穴压豆、耳针、穴位电刺激、隔药饼电子灸、耳穴磁疗、中药封包热敷、推拿9种中医外治法。在改善髋部疼痛视觉模拟量表评分方面,不同中医外治法的疗效排序为针刺+常规西药治疗(SUCRA=100%)>隔药饼电子灸+常规西药治疗(SUCRA=58.2%)>耳穴压豆+常规西药治疗(SUCRA=31.5%)>常规西药治疗(SUCRA=10.3%); 在改善Harris髋关节评分方面,不同中医外治法的疗效排序为推拿+常规西药治疗(SUCRA=68.3%)>中药封包热敷+常规西药治疗(SUCRA=64.5%)>耳针+常规西药治疗(SUCRA=60.5%)>腕踝针+常规西药治疗(SUCRA=45.1%)>常规西药治疗(SUCRA=11.6%); 在安全性方面,不同中医外治法的排序为耳针+常规西药治疗(SUCRA=90.9%)>隔药饼电子灸+常规西药治疗(SUCRA=58.4%)>中药封包热敷+常规西药治疗(SUCRA=57.8%)>腕踝针+常规西药治疗(SUCRA=57.0%)>针刺+常规西药治疗(SUCRA=55.7%)>耳穴压豆+常规西药治疗(SUCRA=55.1%)>穴位电刺激+常规西药治疗(SUCRA=41.8%)>耳穴磁疗+常规西药治疗(SUCRA=28.1%)>常规西药治疗(SUCRA=5.0%)。结论:现有证据表明,全髋关节置换术后应用中医外治法联合常规西药治疗能够缓解术后髋部疼痛、改善髋关节功能,且安全性高; 在常规西药治疗的基础上,针刺在缓解术后髋部疼痛方面更具优势、推拿在改善髋关节功能方面更具优势、耳针在安全性方面更具优势。
Abstract:
Objective:To systematically review the therapeutic efficacy and safety of different Traditional Chinese Medicine(TCM)external therapies following total hip arthroplasty(THA).Methods:All the comparative study articles about application of different TCM external therapies after THA included from database's inception to July 1,2024 were retrieved from the China National Knowledge Infrastructure,Vip Database,Wanfang Database,Chinese Biomedical Literature Service System,PubMed,Embase,Cochrane Library,and Web of Science through computer.The patients in experiment group were treated with TCM external therapies and conventional Western medicine (CWM)after THA,while the ones in control group with CWM 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 software,and a reticulated Meta-analysis was conducted.Furthermore,the efficacies and safety of the adopted TCM external therapies were ranked according to the surface under the cumulative ranking curve(SUCRA).Results:Two thousand two hundred and nineteen articles were searched out.After screening,17 articles were included in the final analysis,involving wrist-ankle acupuncture(WAA)therapy,acupuncture therapy,auricular plastertherapy,auricular acupuncture therapy,transcutaneous electrical acupoint stimulation(TEAS)therapy,herbal cake-separated electronic moxibustion therapy,auricular magnetotherapy,herbal packing hot compress therapy,and Tui Na therapy.The reticulated Meta-analysis revealed that acupuncture therapy combined with CWM(SUCRA=100%)exhibited greater superiority in improving hip pain visual analogue scale score,followed by herbal cake-separated electronic moxibustion therapy combined with CWM(SUCRA=58.2%),auricular plastertherapy combined with CWM(SUCRA=31.5%),and CWM alone(SUCRA=10.3%); Tui Na therapy combined with CWM(SUCRA=68.3%)behaved best in improving Harris hip score,followed by herbal packing hot compress therapy combined with CWM(SUCRA=64.5%),auricular acupuncture therapy combined with CWM(SUCRA=60.5%),WAA therapy combined with CWM(SUCRA=45.1%),and CWM alone(SUCRA=11.6%); auricular acupuncture therapy combined with CWM(SUCRA=90.9%)performed best in the safety profile,followed by herbal cake-separated electronic moxibustion therapy combined with CWM(SUCRA=58.4%),herbal packing hot compress therapy combined with CWM(SUCRA=57.8%),WAA therapy combined with CWM(SUCRA=57.0%),acupuncture therapy combined with CWM(SUCRA=55.7%),auricular plaster therapy combined with CWM(SUCRA=55.1%),TEAS therapy combined with CWM(SUCRA=41.8%),auricular magnetotherapy combined with CWM(SUCRA=28.1%),and CWM alone(SUCRA=5.0%).Conclusion:Available evidences suggest that,application of TCM external therapies combined with CWM after THA can effectively alleviate postoperative hip pain and improve hip joint function,with a high safety profile.Among the 9 TCM external therapies,the acupuncture therapy combined with CWM exhibits greater superiority in alleviating postoperative hip pain,the Tui Na therapy combined with CWM behaves best in improving hip joint function,and the auricular acupuncture therapy combined with CWM performs best in the safety profile.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金项目(82274544,82004392)
通讯作者:何伟 E-mail:hw13802516062@163.com
更新日期/Last Update: 1900-01-01