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[1]范奕松,俞桂松,唐振坤,等.補(bǔ)腎活血湯治療股骨頭壞死的系統(tǒng)評(píng)價(jià)[J].中醫(yī)正骨,2020,32(03):26-34.
　FAN Yisong,YU Guisong,TANG Zhenkun,et al.Systematic review on Bushen Huoxue Tang(補(bǔ)腎活血湯)for treatment of osteonecrosis of the femoral head[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2020,32(03):26-34.
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補(bǔ)腎活血湯治療股骨頭壞死的系統(tǒng)評(píng)價(jià)()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第32卷
期數(shù):
2020年03期
頁(yè)碼:
26-34
欄目:
文獻(xiàn)研究
出版日期:
2020-03-20

文章信息/Info

Title:
Systematic review on Bushen Huoxue Tang(補(bǔ)腎活血湯)for treatment of osteonecrosis of the femoral head
作者:
范奕松1; 俞桂松1; 唐振坤1; 肖魯偉2; 童培建2
(1.浙江中醫(yī)藥大學(xué)第一臨床醫(yī)學(xué)院,浙江 杭州 310053; 2.浙江省中醫(yī)院,浙江 杭州 310006)
Author(s):
FAN Yisong1; YU Guisong1; TANG Zhenkun1; XIAO Luwei2; TONG Peijian2
1.The First Clinical Medical College of Zhejiang Chinese Medical University,Hangzhou 310053,Zhejiang,China 2.Zhejiang Provincial Hospital of Traditional Chinese Medicine,Hangzhou 310006,Zhejiang,China
關(guān)鍵詞:
股骨頭壞死;  補(bǔ)腎活血湯;  Meta分析;  系統(tǒng)評(píng)價(jià)
Keywords:
femur head necrosis;  Bushen Huoxue Tang;  meta-analysis;  systematic review
摘要:
目的:評(píng)價(jià)補(bǔ)腎活血湯治療股骨頭壞死(osteonecrosis of the femoral head,ONFH)的臨床療效和安全性。方法:計(jì)算機(jī)檢索中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù)、中國(guó)知網(wǎng)、萬(wàn)方醫(yī)學(xué)網(wǎng)、維普網(wǎng)建庫(kù)至 2019年2月收錄的所有補(bǔ)腎活血湯治療ONFH的隨機(jī)對(duì)照研究文獻(xiàn)。篩選文獻(xiàn)后提取數(shù)據(jù),采用Cochrane文獻(xiàn)質(zhì)量評(píng)價(jià)標(biāo)準(zhǔn)和Jadad評(píng)分量表對(duì)納入的文獻(xiàn)進(jìn)行質(zhì)量評(píng)估,采用Revman5.3軟件進(jìn)行Meta分析。結(jié)果:納入19篇文獻(xiàn),涉及1717例ONFH患者。19篇文獻(xiàn)研究質(zhì)量均較低,Jadad評(píng)分均≤2分。Meta分析結(jié)果顯示,治療組的總有效率高于對(duì)照組[I2=0%,OR=3.53,95%CI(2.63,4.75)]; 治療后的Harris評(píng)分總分、Harris髖關(guān)節(jié)疼痛評(píng)分、Harris髖關(guān)節(jié)活動(dòng)度評(píng)分及Harris髖關(guān)節(jié)功能評(píng)分均高于對(duì)照組[I2=98%,WMD=10.62,95%CI(5.55,15.69); I2=87%,WMD=5.03,95%CI(3.02,7.04); I2=98%,WMD=0.82,95%CI(0.06,1.58); I2=47%,WMD=5.17,95%CI(3.60,6.75)]; 治療后的低密度脂蛋白膽固醇、總膽固醇及甘油三酯均低于對(duì)照組[I2=31%,WMD=-0.47,95%CI(-0.66,-0.27); I2=50%,WMD=-0.31,95%CI(-0.51,-0.12); I2=0%,WMD=-0.16,95%CI(-0.23,-0.10)]; 治療后的血漿黏度、全血黏度高切值、全血黏度低切值和紅細(xì)胞比容均低于對(duì)照組[I2=0%,WMD=-0.20,95%CI(-0.27,-0.12); I2=80%,WMD=-0.75,95%CI(-1.24,-0.26); I2=96%,WMD=-1.43,95%CI(-3.12,-0.25); I2=76%,WMD=-3.29,95%CI(-4.63,-1.95)]; 治療后的髖關(guān)節(jié)疼痛視覺(jué)模擬量表評(píng)分低于對(duì)照組[I2=0%,WMD=-1.65,95%CI(-1.82,-1.48)]; 5篇文獻(xiàn)對(duì)不良反應(yīng)發(fā)生情況作了說(shuō)明,其中只有2篇文獻(xiàn)描述了不良反應(yīng)的具體情況,2組的不良反應(yīng)發(fā)生率比較,差異無(wú)統(tǒng)計(jì)學(xué)意義[I2=0%,OR=1.00,95%CI(0.34,2.98)]。以總有效率進(jìn)行發(fā)表偏倚分析,偏倚漏斗圖顯示兩側(cè)分布不均,提示可能存在發(fā)表偏倚。結(jié)論:現(xiàn)有的證據(jù)表明,采用補(bǔ)腎活血湯治療ONFH,能有效緩解患者的髖關(guān)節(jié)疼痛癥狀、改善髖關(guān)節(jié)功能、降低血脂及血漿黏度,臨床療效確切; 現(xiàn)有研究對(duì)干預(yù)措施的安全性重視程度不夠,關(guān)于補(bǔ)腎活血湯治療ONFH的安全性仍需更多臨床研究予以驗(yàn)證; 納入的研究質(zhì)量較低、證據(jù)等級(jí)強(qiáng)度不足,所得結(jié)論需要更多高質(zhì)量文獻(xiàn)和更加科學(xué)合理的證據(jù)加以印證。
Abstract:
Objective:To evaluate the clinical curative effects and safety of Bushen Huoxue Tang(補(bǔ)腎活血湯,BSHXT)for treatment of osteonecrosis of the femoral head(ONFH).Methods:All randomized controlled trial(RCT)articles about BSHXT for treatment of ONFH included from database establishing to February 2019 were retrieved from Chinese biomedical literature database,China national knowledge internet,WanFang Database and VIP Database through computer.The articles were screened and the information was extracted.The methodological quality of research in the articles was evaluated by using Cochrane literature quality evaluation criteria and Jadad scale and a Meta-analysis was conducted by using Revman 5.3 software.Results:Nineteen articles(1717 ONFH patients)were included in the final analysis.The Jadad scores of included articles were ≤2 points,and it suggested that the quality of these articles was poor.The results of Meta-analysis demonstrated that the total effective rate was higher in treatment group compared to control group(I2=0%,OR=3.53,95%CI(2.63,4.75)).The posttreatment Harris hip scores including total scores,pain scores,ROM scores and function scores were higher in treatment group compared to control group(I2=98%,WMD=10.62,95%CI(5.55,15.69); I2=87%,WMD=5.03,95%CI(3.02,7.04); I2=98%,WMD=0.82,95%CI(0.06,1.58); I2=47%,WMD=5.17,95%CI(3.60,6.75)).The posttreatment low density lipoprotein cholesterol,total cholesterol and triglyceride were lower in treatment group compared to control group(I2=31%,WMD=-0.47,95%CI(-0.66,-0.27); I2=50%,WMD=-0.31,95%CI(-0.51,-0.12); I2=0%,WMD=-0.16,95%CI(-0.23,-0.10)).The posttreatment plasma viscosity,high and low shear whole blood viscosity and hematocrit were lower in treatment group compared to control group(I2=0%,WMD=-0.20,95%CI(-0.27,-0.12); I2=80%,WMD=-0.75,95%CI(-1.24,-0.26); I2=96%,WMD=-1.43,95%CI(-3.12,-0.25); I2=76%,WMD=-3.29,95%CI(-4.63,-1.95)).The posttreatment hip visual analogue scale scores were lower in treatment group compared to control group(I2=0%,WMD=-1.65,95%CI(-1.82,-1.48)).The occurrence of adverse reactions were described in 5 articles,while the specific adverse reactions were described in only 2 articles.There was no statistical difference in the incidence rate of adverse reactions between treatment group and control group(I2=0%,OR=1.00,95%CI(0.34,2.98)).Publication bias was analyzed according to the total effective rate,and the asymmetrical funnel plot demonstrated that there might be publication bias.Conclusion:Available evidences suggest that oral application of BSHXT can effectively relieve hip pain,improve hip function and reduce blood lipid and plasma viscosity in treatment of ONFH,and its clinical effect is definite.However,less attention is paid to the safety of interventions in present studies,therefore,the safety of BSHXT in treatment of ONFH need to be further verified by more clinical studies.The quality of included articles is poor and the level of evidence is insufficient,so the obtained conclusions need to be confirmed by more high-quality articles and more scientific and rational evidences.

參考文獻(xiàn)/References:

[1] 譚鋼,羅磊,楊靜,等.3664例全髖關(guān)節(jié)置換術(shù)相關(guān)危險(xiǎn)因素分析[J].中國(guó)矯形外科雜志,2011,19(17):1431-1434.
[2] 郭效東,陳衛(wèi)衡,趙永剛,等.股骨頭無(wú)菌性壞死三期辨證論治的臨床研究[J].中國(guó)骨傷,1995,8(6):19-20.
[3] JADAD A R,MOORE R A,CARROLL D,et al.Assessing the quality of reports of randomized clinical trials:is blinding necessary?[J].Controlled clinical trials,1996,17(1):1-12.
[4] 張雪鵬,郜中明,卞華.補(bǔ)腎活血湯結(jié)合鉆孔減壓術(shù)治療股骨頭缺血性壞死的臨床觀察[J].科學(xué)技術(shù)與工程,2014,14(26):187-189.
[5] 劉金豹,李剛.靶向性鉆孔減壓聯(lián)合辛伐他汀、補(bǔ)腎活血湯治療早期激素性股骨頭壞死的臨床觀察[J].中國(guó)中醫(yī)基礎(chǔ)醫(yī)學(xué)雜志,2017,23(12):1739-1741.
[6] 蘇亞.補(bǔ)腎活血湯結(jié)合鉆孔減壓術(shù)治療早期成人股骨頭壞死臨床研究[J].亞太傳統(tǒng)醫(yī)藥,2017,13(15):133-134.
[7] 曾祥晶.髓芯減壓擴(kuò)大植骨術(shù)配合補(bǔ)腎活血湯治療早期非創(chuàng)傷性股骨頭壞死療效分析[J].實(shí)用中醫(yī)藥雜志,2017,33(4):386-387.
[8] 柳錦華,劉建衛(wèi).補(bǔ)腎活血湯治療中老年激素性股骨頭壞死的臨床效果分析[J].齊齊哈爾醫(yī)學(xué)院學(xué)報(bào),2016,37(33):4174-4176.
[9] 張超,姚晨,沈計(jì)榮.微創(chuàng)髓芯減壓打壓支撐植骨術(shù)結(jié)合補(bǔ)腎活血湯口服治療ARCOⅡ、Ⅲ期股骨頭壞死的近期療效觀察[J].中醫(yī)正骨,2016,28(3):20-23.
[10] 李煒.補(bǔ)腎活血湯治療成人早期股骨頭缺血性壞死30例[J].河南中醫(yī),2013,33(4):559-560.
[11] 滕居贊,蘇波,王大偉.補(bǔ)腎活血湯加減聯(lián)合雷火灸治療股骨頭缺血性壞死30例臨床觀察[J].河北中醫(yī),2013,35(4):491-493.
[12] 馬紅英,牟成林,張均喜,等.補(bǔ)腎活血湯配合髓芯減壓術(shù)治療早期成人股骨頭缺血性壞死療效觀察[J].現(xiàn)代中西醫(yī)結(jié)合雜志,2011,20(16):1988-1989.
[13] 許興輝.補(bǔ)腎活血方配合髓芯減壓植骨內(nèi)支撐術(shù)治療早期股骨頭壞死的臨床效果[J].中國(guó)醫(yī)藥導(dǎo)報(bào),2017,14(16):98-101.
[14] 章恒,曾明珠,馮強(qiáng).補(bǔ)腎活血方聯(lián)合銀質(zhì)針導(dǎo)熱治療早中期股骨頭壞死臨床研究[J].新中醫(yī),2014,46(2):103-105.
[15] 馬國(guó)華.補(bǔ)腎活血方配合髓芯減壓術(shù)治療早期股骨頭缺血性壞死臨床觀察[J].中國(guó)中醫(yī)急癥,2009,18(4):547-548.
[16] 滕加文.補(bǔ)腎活血湯治療股骨頭缺血性壞死45例[J].山東中醫(yī)藥大學(xué)學(xué)報(bào),2011,35(1):36-37.
[17] 金慶平.補(bǔ)腎活血湯治療激素性股骨頭壞死的臨床療效觀察[D].哈爾濱:黑龍江中醫(yī)藥大學(xué),2009.
[18] 董小明.補(bǔ)腎活血湯治療早期股骨頭壞死的臨床療效觀察[D].烏魯木齊:新疆醫(yī)科大學(xué),2013.
[19] 宜娟娟,曹玉舉.活血補(bǔ)腎湯治療股骨頭壞死療效觀察[J].按摩與康復(fù)醫(yī)學(xué),2016,7(1):20-22.
[20] 李宏達(dá).補(bǔ)腎活血湯治療股骨頭壞死69例[J].中外健康文摘,2009,6(20):218-219.
[21] 高鑫.帶血管蒂髂骨瓣移植配合活血補(bǔ)腎湯治療股骨頭缺血性壞死療效觀察[J].實(shí)用中醫(yī)藥雜志,2018,34(3):344-345.
[22] 蒙錫波,鄧麗麗.恒古骨傷愈合劑聯(lián)合活血補(bǔ)腎湯治療激素性股骨頭壞死療效及對(duì)骨密度的影響[J].現(xiàn)代中西醫(yī)結(jié)合雜志,2018,27(1):82-85.
[23] 郝琦,劉華輝,劉金龍,等.徐組健教授探討經(jīng)典醫(yī)集辯證治療股骨頭缺血壞死[J].臨床醫(yī)藥文獻(xiàn)電子雜志,2019,6(12):79.
[24] 于潼,謝利民.股骨頭壞死的中醫(yī)病因病機(jī)及辨證分型的探討[J].北京中醫(yī)藥,2010,29(5):393-396.
[25] 劉伯齡,趙文海.股骨頭無(wú)菌性壞死的辨證施治[J].中國(guó)骨傷,1991,4(1):1-4.
[26] 顧磊.髓芯減壓植骨腓骨棒支撐術(shù)聯(lián)合補(bǔ)腎活血湯治療早中期股骨頭壞死臨床療效觀察[D].南京:南京中醫(yī)藥大學(xué),2017.
[27] 厲駒.補(bǔ)腎法在股骨頭壞死治療中的應(yīng)用[J].浙江中醫(yī)藥大學(xué)學(xué)報(bào),2012,36(5):482-483.
[28] 于恒恒.細(xì)針多孔道髓芯減壓術(shù)聯(lián)合補(bǔ)腎活血湯治療早期非創(chuàng)傷性股骨頭壞死的療效觀察[D].南京:南京中醫(yī)藥大學(xué),2018.
[29] 陳學(xué)先.補(bǔ)腎活血湯加減治療股骨頭缺血性壞死27例[J].中醫(yī)臨床研究,2014,6(28):63-64.
[30] 魏秋實(shí),何偉,張慶文,等.股骨頭壞死中醫(yī)證型分布規(guī)律的文獻(xiàn)研究和系統(tǒng)評(píng)價(jià)[J].中華關(guān)節(jié)外科雜志(電子版),2013,7(3):369-372.
[31] 姚晨,沈計(jì)榮,杜斌,等.口服補(bǔ)腎活血湯聯(lián)合微創(chuàng)保髖術(shù)治療股骨頭壞死腎虛血瘀證的臨床研究[J].中醫(yī)正骨,2016,28(11):7-12.
[32] 單方軍,肖魯偉.中藥加功能鍛練治療輕度膝關(guān)節(jié)骨性關(guān)節(jié)炎的療效分析[J].黑龍江中醫(yī)藥,2013,42(4):28-29.
[33] 周李學(xué),李志敏,段璋,等.補(bǔ)腎活血湯對(duì)激素性股骨頭缺血壞死骨材料力學(xué)的影響[J].福建中醫(yī)藥,2016,47(1):26-29.
[34] 周丕琪.補(bǔ)腎方治療骨痹證(腎虛型)的臨床觀察及相關(guān)指標(biāo)測(cè)定[D].武漢:華中科技大學(xué),2008.
[35] 李建輝.補(bǔ)腎活血湯防治家兔激素性股骨頭壞死的實(shí)驗(yàn)研究[D].成都:成都中醫(yī)藥大學(xué),2009.
[36] 顏冰,王和鳴.活血補(bǔ)腎湯對(duì)兔激素性股骨頭壞死VEGF的影響[J].中國(guó)中醫(yī)骨傷科雜志,2010,18(5):1-4.
[37] ZHANG Q,YANG F,CHEN Y,et al.Chinese herbal medicine formulas as adjuvant therapy for osteonecrosis of the femoral head:a systematic review and meta-analysis of randomized controlled trials[J].Medicine,2018,97(36):e12196.

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[3]周勇,任菲菲,豐凡翔,等.血管內(nèi)皮生長(zhǎng)因子和骨形態(tài)發(fā)生蛋白2 在非創(chuàng)傷性股骨頭壞死不同區(qū)域的表達(dá)[J].中醫(yī)正骨,2015,27(08):7.
　ZHOU Yong,REN Feifei,FENG Fanxiang,et al.Expressions of vascular endothelial growth factor and bone morphogenetic protein 2 in different zones of femoral head with non-traumatic osteonecrosis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(03):7.
[4]鮑榮華,王國(guó)平,夏曉斌,等.鉭棒植入治療非創(chuàng)傷性股骨頭壞死的療效觀察[J].中醫(yī)正骨,2015,27(02):28.
[5]張兵,馬凰富,劉波,等.非創(chuàng)傷性股骨頭壞死的舌象定量研究[J].中醫(yī)正骨,2015,27(04):8.
　ZHANG Bing,MA Huangfu,LIU Bo,et al.Quantitative study on tongue manifestation of patients with nontraumatic osteonecrosis of femoral head[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(03):8.
[6]李剛,程春生.股骨頭壞死血瘀證癥狀與平樂(lè)郭氏正骨方藥藥物組成 最大頻繁關(guān)聯(lián)模式挖掘[J].中醫(yī)正骨,2015,27(04):21.
　LI Gang,CHENG Chunsheng.Maximal frequent association pattern mining for studying the relationship between BLOOD STASIS syndrome in patients with osteonecrosis of femoral head and drug components of Pingle Guo's orthopedics prescription[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(03):21.
[7]李文龍,梅沉成,杜貴強(qiáng),等.微創(chuàng)減壓植骨多孔鉭棒植入治療 ARCOⅡ期非創(chuàng)傷性缺血性股骨頭壞死[J].中醫(yī)正骨,2016,28(02):43.
[8]張磊,金紅婷,童培建.骨健口服液早期干預(yù)非創(chuàng)傷性股骨頭壞死的臨床研究[J].中醫(yī)正骨,2016,28(03):14.
　ZHANG Lei,JIN Hongting,TONG Peijian.Clinical study on Gujian Koufuye(骨健口服液)for early intervention of nontraumatic osteonecrosis of femoral head[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(03):14.
[9]鮑榮華,王國(guó)平,夏曉斌,等.直接前入路微創(chuàng)全髖關(guān)節(jié)置換術(shù)治療晚期股骨頭壞死[J].中醫(yī)正骨,2016,28(03):61.
[10]唐立明,龐智暉,樊粵光,等.“辨穩(wěn)論治”微觀辨證理念指導(dǎo)下的股骨頭壞死圍塌陷期分型及其臨床應(yīng)用價(jià)值[J].中醫(yī)正骨,2016,28(05):63.
[11]張超,姚晨,沈計(jì)榮.微創(chuàng)髓芯減壓打壓支撐植骨術(shù)結(jié)合補(bǔ)腎活血湯口服治療ARCOⅡ、Ⅲ期股骨頭壞死的近期療效觀察[J].中醫(yī)正骨,2016,28(03):20.
　ZHANG Chao,YAO Chen,SHEN Jirong.[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(03):20.
[12]姚晨,沈計(jì)榮,杜斌,等.口服補(bǔ)腎活血湯聯(lián)合微創(chuàng)保髖術(shù)治療股骨頭壞死腎虛血瘀證的臨床研究[J].中醫(yī)正骨,2016,28(11):7.
　YAO Chen,SHEN Jirong,DU Bin,et al.Clinical study on oral application of Bushen Huoxue Tang(補(bǔ)腎活血湯)combined with minimally invasive hip-preserving surgery for treatment of kidney-deficiency-blood-stasis-type osteonecrosis of femoral head[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(03):7.
[13]夏天衛(wèi),李若頎,環(huán)大維,等.基于網(wǎng)絡(luò)藥理學(xué)方法探究補(bǔ)腎活血湯治療激素性股骨頭壞死的作用機(jī)制[J].中醫(yī)正骨,2020,32(03):14.
　XIA Tianwei,LI Ruoqi,HUAN Dawei,et al.A study of mechanism of action of Bushen Huoxue Tang(補(bǔ)腎活血湯)for treatment of steroid-induced osteonecrosis of the femoral head using network pharmacology approach[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2020,32(03):14.

備注/Memo

備注/Memo:
(收稿日期:2019-06-25 本文編輯:李曉樂(lè))基金項(xiàng)目:國(guó)家自然科學(xué)基金項(xiàng)目(81873325) 通訊作者:肖魯偉 E-mail:519512415@qq.com
更新日期/Last Update: 2020-03-10