[1]李兆勇,杨少锋,张晨阳.补肾活血方联合经皮椎体强化术治疗骨质疏松性椎体压缩骨折的系统评价[J].中医正骨,2019,31(03):28-32.
　LI Zhaoyong,YANG Shaofeng,ZHANG Chenyang.Oral application of Bushen Huoxue Fang(补肾活血方)combined with percutaneous vertebral augmentation for treatment of osteoporotic vertebral compression fractures:a systematic review[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2019,31(03):28-32.
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补肾活血方联合经皮椎体强化术治疗骨质疏松性椎体压缩骨折 的系统评价()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第31卷
期数:
2019年03期
页码:
28-32
栏目:
文献研究
出版日期:
2019-03-20

文章信息/Info

Title:
Oral application of Bushen Huoxue Fang(补肾活血方)combined with percutaneous vertebral augmentation for treatment of osteoporotic vertebral compression fractures:a systematic review
作者:
李兆勇1; 杨少锋1; 张晨阳2
(1.湖南中医药大学第一附属医院,湖南 长沙 410007; 2.湖南中医药大学,湖南 长沙 410208)
Author(s):
LI Zhaoyong1; YANG Shaofeng1; ZHANG Chenyang2
1.The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine,Changsha 410007,Hunan,China 2. Hunan University of Traditional Chinese Medicine,Changsha 410208,Hunan,China
关键词:
骨质疏松性骨折;  脊柱骨折;  补肾活血方;  椎体成形术;  椎体后凸成形术;  Meta分析;  系统评价
Keywords:
osteoporotic fractures;  spinal fractures;  Bushen Huoxue Fang;  vertebroplasty;  kyphoplasty;  meta-analysis;  systematic review
摘要:
目的:评价补肾活血方联合经皮椎体强化术治疗骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture,OVCF)的临床疗效和安全性。方法:应用计算机检索中国知网、维普网、万方数据库2010年1月1日至2018年10月12日收录的有关补肾活血方联合经皮椎体强化术(治疗组)和单纯经皮椎体强化术(对照组)治疗OVCF的随机对照临床研究文献。由2位研究者独立筛选文献、提取资料,依据Jadad量表进行文献方法学质量评价后,采用RevMan4.2.7软件进行Meta分析。结果:最初共检索到136篇文献,经筛选后最终纳入14篇文献,均为中文文献。Meta分析结果显示,与对照组相比,治疗组的治疗有效率更高[OR=4.06,95% CI(2.26,7.30)]、治疗后的疼痛视觉模拟量表评分更低[WMD=-0.97,95% CI(-1.50,-0.44)]; 2组治疗后的骨密度比较,差异无统计学意义[WMD=0.05,95% CI(-0.01,0.11)]; 仅有1篇文献比较了2组的并发症,且2组均未出现并发症,故无法进行合并分析。利用治疗后疼痛视觉模拟量表评分进行发表偏倚分析,漏斗图显示分布不对称,提示可能存在潜在的发表偏倚。结论:补肾活血方联合经皮椎体强化术是治疗OVCF的有效方法,其疗效优于单纯经皮椎体强化术。
Abstract:
Objective:To evaluate the clinical curative effects and safety of oral application of Bushen Huoxue Fang(补肾活血方,BSHXF)combined with percutaneous vertebral augmentation for treatment of osteoporotic vertebral compression fractures(OVCF).Methods:All the randomized controlled trial(RCT)articles about combination therapy of oral application of BSHXF and percutaneous vertebral augmentation(treatment group)versus monotherapy of percutaneous vertebral augmentation(control group)for treatment of OVCF included from January 1,2010 to October 12,2018 were retrieved from China national knowledge internet,VIP Database and WanFang Database through computer.The articles were screened and the information was extracted independently by two searchers.The methodological quality of research in the articles was evaluated by using Jadad scale and a Meta-analysis was conducted by using RevMan4.2.7 software.Results:One hundred and thirty-six articles were searched out in the initial stage.After screening,14 Chinese articles were included in the final analysis.The results of Meta-analysis demonstrated that the effective rates were higher and the posttreatment pain visual analogue scale(VAS)scores were lower in treatment group compared to control group(OR=4.06,95% CI(2.26,7.30); WMD=-0.97,95% CI(-1.50,-0.44)).There was no statistical difference in posttreatment bone mineral density between the 2 groups(WMD=0.05,95% CI(-0.01,0.110)).The complication rates were compared between the 2 groups in 1 article and no complications were found in the 2 groups,so merged analysis could not be conducted.Publication bias was analyzed according to posttreatment pain VAS scores,and the asymmetrical funnel plot demonstrated that there was potential publication bias.Conclusion:The combination therapy of oral application of BSHXF and percutaneous vertebral augmentation is an effective method for treatment of OVCF,and it surpasses the monotherapy of percutaneous vertebral augmentation in the clinical curative effect.

参考文献/References:

[1] 印平,马远征,马迅,等.骨质疏松性椎体压缩性骨折的治疗指南[J].中国骨质疏松杂志,2015,21(6):643-648. [2] CURTIS E M,MOON R J,DENNISON E M,et al.Recent advances in the pathogenesis and treatment of osteoporosis[J].Clin Med(Lond),2015,15(Suppl 6):s92-s96. [3] KENDLER D L,BAUER D C,DAVISON K S,et al.Vertebral fractures:clinical importance and management[J].Am J Med,2016,129(2):e1-e10. [4] 董继胜,董力军,闫兵勇,等.经皮椎体成形术和经皮椎体后凸成形术治疗老年骨质疏松椎体压缩性骨折的疗效观察[J].中国矫形外科杂志,2015,23(8):748-751. [5] TAKAHARA K,KAMIMURA M,MORIYA H,et al.Risk factors of adjacent vertebral collapse after percutaneous vertebroplasty for osteoporotic vertebral fracture in postmenopausal women[J].BMC Musculoskelet Disord,2016,17(1):12. [6] ZHAO G,LIU X,LI F.Balloon kyphoplasty versus percutaneous vertebroplasty for treatment of osteoporotic vertebral compression fractures(OVCFs)[J].Osteoporos Int,2016,27(9):2823-2834. [7] 刘守海,黄仲玉.益肾活血通络汤治疗原发性骨质疏松症30例总结[J].湖南中医杂志,2013,29(8):56-57. [8] 邱贵兴,裴福兴,胡侦明,等.中国骨质疏松性骨折诊疗指南(骨质疏松性骨折诊断及治疗原则)[J].中华骨与关节外科杂志,2015,9(5):371-374. [9] JADAD A R,MOORE R A,CARROLL D,et al.Assessing the quality of reports of randomized clinical trials:is blinding necessary?[J].Control Clin Trials,1996,17(1):1-12. [10] 刘波,吕刚,杨宏.补肾活血汤联合经皮椎体后凸成形术治疗老年骨质疏松性椎体压缩性骨折的临床观察[J].老年医学与保健,2017,23(3):216-219. [11] 王振东,关智媛,关永林,等.补肾活血汤治疗老年骨质疏松性椎体骨折PKP术后临床观察[J].实用中西医结合临床,2017,17(7):116-118. [12] 莫元森.PKP联合补肾活血汤治疗胸腰椎压缩性骨折疗效分析[J].当代医学,2016,22(24):159-160. [13] 韩庭良,王国军,尹佩玉,等.PKP联合补肾活血方治疗骨质疏松椎体压缩骨折的临床研究[J].中国中医骨伤科杂志,2016,24(10):35-39. [14] 冯美楷,冯春,赵军军,等.经皮球囊扩张椎体后凸成形术联合补肾活血汤治疗老年骨质疏松性胸腰椎骨折的临床研究[J].时珍国医国药,2016,27(11):2690-2691. [15] 唐东鸣.补肾活血方治疗老年骨质疏松性椎体压缩性骨折29例[J].河南中医,2014,34(4):664-665. [16] 石树培,姚东文,林翔,等.补肾活血汤配合PKP治疗骨质疏松性胸腰椎压缩性骨折23例临床观察[J].福建中医药大学学报,2013,23(4):55-57. [17] 甘发荣,张泰标,胡万钧,等.补肾活血汤联合经皮椎体成形术治疗骨质疏松性胸腰椎压缩骨折的疗效分析[J].中国骨质疏松杂志,2018,24(4):526-529. [18] 黄琛,黄浩,艾志,等.补肾活血汤联合经皮锥体成形术对老年骨质疏松性椎体压缩性骨折的疗效及其安全性观察[J].中华中医药学刊,2018,36(3):719-722. [19] 曾伟权.补肾活血中药联合PVP对老年骨质疏松性椎体压缩性骨折的治疗分析[J].中医临床研究,2016,8(31):57-58. [20] 杨广营,王培洋.经皮椎体成形术联合补肾活血汤治疗椎体压缩性骨折疗效观察[J].河南医学高等专科学校学报,2015,27(3):289-290. [21] 蒋卫方.椎体成形术配合补肾活血中药治疗骨质疏松性胸腰椎骨折51例临床观察[J].江苏中医药,2013,45(12):38-39. [22] 柴仪,李倩,田伟明,等.补肾活血中药对椎体成形术后患者的视觉模拟评分及骨密度的影响[J].河北中医药学报,2013,28(4):6-8. [23] 张华龙.手术联合补肾活血中药治疗骨质疏松性胸腰椎压缩性骨折20例[J].中医药导报,2010,16(4):49-50. [24] 国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:173-176. [25] 周旭毓,方积乾.Meta分析的常见偏倚[J].循证医学,2002,2(4):216-220.

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备注/Memo

备注/Memo:
基金项目:湖南省自然科学基金项目(2017JJ2208) 通讯作者:杨少锋 E-mail:574996585@qq.com(收稿日期:2018-11-13 本文编辑:李晓乐)
更新日期/Last Update: 2019-03-30