[1]孟祥亚,马士超,陈秀民.补阳还五汤预防全髋关节置换术后深静脉血栓形成有效性和安全性的mETA分析[J].中医正骨,2023,35(11):37-43.
　MENG Xiangya,MA Shichao,CHEN Xiumin.Clinical outcomes and safety of Buyang Huanwu Tang(补阳还五汤)for prevention of deep vein thrombosis after total hip arthroplasty:a meta-analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2023,35(11):37-43.
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补阳还五汤预防全髋关节置换术后深静脉血栓形成有效性和安全性的mETA分析()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第35卷
期数:
2023年11期
页码:
37-43
栏目:
文献研究
出版日期:
2023-11-20

文章信息/Info

Title:
Clinical outcomes and safety of Buyang Huanwu Tang(补阳还五汤)for prevention of deep vein thrombosis after total hip arthroplasty:a meta-analysis
作者:
孟祥亚1; 马士超2; 陈秀民2
1.河南中医药大学骨伤学院,河南 郑州 450002; 2.濮阳市中医医院,河南 濮阳 457003
Author(s):
MENG Xiangya1; MA Shichao2; CHEN Xiumin2
1.College of Orthopaedics and Traumatology of Henan University of Chinese Medicine,Zhengzhou 450002,Henan,China 2.Chinese Medicine Hospital of Puyang,Puyang 457003,Henan,China
关键词:
补阳还五汤;  关节成形术; 置换; 髋;  静脉血栓形成;  专题Meta分析
Keywords:
Buyang Huanwu Tang;  arthroplasty; replacement; hip;  venous thrombosis;  meta-analysis as topic
摘要:
目的:系统评价补阳还五汤预防全髋关节置换术后深静脉血栓形成(deep vein thrombosis,DVT)的有效性和安全性。方法:应用计算机检索中国知网、万方数据库、维普网、中国生物医学文献服务系统、PubMed、Cochrane Library、Embase、Web of Science,筛选补阳还五汤预防全髋关节置换术后DVT的随机对照试验,检索时限均为建库至2023年9月。试验组采用补阳还五汤治疗或补阳还五汤联合抗凝药物治疗,对照组采用抗凝药物治疗。由2名研究人员独立筛选文献、提取数据并评价纳入研究的偏倚风险后,采用RevMan5.4软件进行Meta分析。结果:共纳入16项研究,涉及1445例患者,其中试验组726例、对照组719例。Meta分析结果显示,术后第7天和术后第14天时,试验组的DVT发生率、血浆D-二聚体水平、血浆纤维蛋白原水平均低于对照组[术后第7天:RR=0.33,95%CI(0.20,0.55),P=0.000; SMD=-0.72,95%CI(-1.11,-0.33),P=0.000; SMD=-0.82,95%CI(-1.27,-0.38),P=0.000; 术后第14天:RR=0.32,95%CI(0.19,0.56),P=0.000; SMD=-1.30,95%CI(-2.35,-0.24),P=0.020; SMD=-1.02,95%CI(-1.86,-0.18),P=0.020]; 试验组的不良反应发生率低于对照组[RR=0.58,95%CI(0.42,0.81),P=0.001]。基于DVT发生率的漏斗图不对称,提示存在发表偏倚的可能。结论:与单独使用抗凝药物相比,全髋关节置换术后单独使用补阳还五汤或联合应用抗凝药物能更好地降低DVT发生率、血浆D-二聚体水平及血浆纤维蛋白原水平,而且安全性更高。
Abstract:
Objective:To systematically review the clinical outcomes and safety of Buyang Huanwu Tang(补阳还五汤,BYHWT)in preventing deep vein thrombosis(DVT)after total hip arthroplasty(THA).Methods:All the randomized controlled trial(RCT)articles about oral application of BYHWT for prevention of DVT after THA included from database establishing to September 2023 were retrieved from the China National Knowledge Internet,Wanfang Database,Vip Database,Chinese Biomedical Literature Service System,PubMed,Cochrane Library,Embase and Web of Science through computer.The patients in experiment group were treated with oral application of BYHWT or combination of BYHWT with anticoagulant drugs,while the ones in control group merely with application of anticoagulant drugs.The articles were screened,the information was extracted and the risk of bias of included researches was assessed independently by two researchers,and then a Meta-analysis was conducted by using RevMan5.4 software.Results:Sixteen articles(1445 patients)were included in the final analysis,726 patients in experiment group and 719 ones in control group.The results of Meta-analysis revealed that,at postsurgical day 7 and 14,the incidence rate of DVT,the plasma levels of D-dimer and fibrinogen were lower in experiment group compared to control group(at postsurgical day 7:RR=0.33,95%CI(0.20,0.55),P=0.000; SMD=-0.72,95%CI(-1.11,-0.33),P=0.000; SMD=-0.82,95%CI(-1.27,-0.38),P=0.000; at postsurgical day 14:RR=0.32,95%CI(0.19,0.56),P=0.000; SMD=-1.30,95%CI(-2.35,-0.24),P=0.020; SMD=-1.02,95%CI(-1.86,-0.18),P=0.020).Moreover,the incidence rate of adverse reactions was lower in experiment group compared to control group(RR=0.58,95%CI(0.42,0.81),P=0.001).Publication bias was analyzed according to funnel plot drawned based on the incidence rate of DVT,and the asymmetrical funnel plot suggested that there might be publication bias.Conclusion:Oral application of BYHWT alone or combination of BYHWT with anticoagulant drugs after THA can better reduce the incidence rate of DVT,decrease the plasma levels of D-dimer and fibrinogen with high safety compared to application of anticoagulant drugs alone.

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备注/Memo

备注/Memo:
基金项目:河南省中医药科学研究专项课题(2022ZY1192)
通讯作者:陈秀民 E-mail:CXm4427744@163.com
更新日期/Last Update: 1900-01-01