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[1]張兵兵,史曉林,吳連國(guó),等.中藥預(yù)防膝關(guān)節(jié)置換術(shù)后深靜脈血栓形成的網(wǎng)狀Meta分析[J].中醫(yī)正骨,2021,33(06):27-35.
　ZHANG Bingbing,SHI Xiaolin,WU Lianguo,et al.Traditional Chinese Medicine therapy for prevention of deep vein thrombosis after the surgery of knee replacement:a network meta-analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(06):27-35.
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中藥預(yù)防膝關(guān)節(jié)置換術(shù)后深靜脈血栓形成的網(wǎng)狀Meta分析()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期數(shù):
2021年06期
頁(yè)碼:
27-35
欄目:
文獻(xiàn)研究
出版日期:
2021-06-20

文章信息/Info

Title:
Traditional Chinese Medicine therapy for prevention of deep vein thrombosis after the surgery of knee replacement:a network meta-analysis
作者:
張兵兵1; 史曉林1; 吳連國(guó)1; 俞興2; 孫永生3
1.浙江中醫(yī)藥大學(xué)附屬第二醫(yī)院,浙江 杭州 310005; 2.北京中醫(yī)藥大學(xué)東直門醫(yī)院,北京 100700; 3.中國(guó)中醫(yī)科學(xué)院望京醫(yī)院,北京 100102
Author(s):
ZHANG Bingbing1;  SHI Xiaolin1; WU Lianguo1; YU Xing2; SUN Yongsheng3
1.The Second Affiliated Hospital of Zhejiang Chinese Medical University,Hangzhou 310005,Zhejiang,China 2.Dongzhimen Hospital of Beijing University of Chinese Medicine,Beijing 100700,China 3.Wangjing Hospital of CACMS,Beijing 100102,China
關(guān)鍵詞:
關(guān)節(jié)成形術(shù); 置換; 膝;  靜脈血栓形成;  中藥療法;  網(wǎng)狀Meta分析
Keywords:
arthroplasty; replacement; knee;  venous thrombosis;  drug therapy(TCD);  Network meta-analysis
摘要:
目的:系統(tǒng)評(píng)價(jià)中藥預(yù)防膝關(guān)節(jié)置換術(shù)后深靜脈血栓形成(deep vein thrombosis,DVT)的臨床療效。方法:應(yīng)用計(jì)算機(jī)檢索中國(guó)知網(wǎng)、萬(wàn)方數(shù)據(jù)庫(kù)、維普網(wǎng)、Medline、Cochrane library、Embase、Web of Science,搜集應(yīng)用中藥預(yù)防膝關(guān)節(jié)置換術(shù)后DVT的隨機(jī)對(duì)照試驗(yàn),檢索時(shí)限均為建庫(kù)至2020年10月1日。經(jīng)過(guò)文獻(xiàn)篩選、數(shù)據(jù)提取及質(zhì)量評(píng)價(jià)后,采用Stata14.0軟件進(jìn)行統(tǒng)計(jì)分析。結(jié)果:共檢索到3748篇相關(guān)文獻(xiàn),最終納入59篇,涉及常規(guī)西醫(yī)療法(《中國(guó)骨科大手術(shù)靜脈血栓栓塞癥預(yù)防指南》推薦的預(yù)防措施)、補(bǔ)氣方藥聯(lián)合常規(guī)西醫(yī)療法、補(bǔ)氣方藥、補(bǔ)益氣血方藥、補(bǔ)益氣血方藥聯(lián)合常規(guī)西醫(yī)療法、補(bǔ)肝腎方藥聯(lián)合常規(guī)西醫(yī)療法及補(bǔ)肝腎方藥共7種干預(yù)措施。網(wǎng)狀Meta分析結(jié)果顯示,補(bǔ)氣方藥聯(lián)合常規(guī)西醫(yī)療法、補(bǔ)益氣血方藥聯(lián)合常規(guī)西醫(yī)療法及補(bǔ)肝腎方藥聯(lián)合常規(guī)西醫(yī)療法預(yù)防膝關(guān)節(jié)置換術(shù)后DVT的效果均優(yōu)于常規(guī)西醫(yī)療法[RR=0.31,95%CI(0.23,0.43); RR=0.27,95%CI(0.10,0.72); RR=0.31,95%CI(0.14,0.71)]; 其余各種干預(yù)措施預(yù)防膝關(guān)節(jié)置換術(shù)后DVT效果的組間差異均無(wú)統(tǒng)計(jì)學(xué)意義。59項(xiàng)研究中的7種干預(yù)措施預(yù)防膝關(guān)節(jié)術(shù)后DVT效果的累積概率排序圖下面積(surface under the cumulative ranking,SUCRA)排序?yàn)檠a(bǔ)益氣血方藥聯(lián)合常規(guī)西醫(yī)療法(SUCRA=84.3%)>補(bǔ)氣方藥聯(lián)合常規(guī)西醫(yī)療法(SUCRA=81.5%)>補(bǔ)肝腎方藥聯(lián)合常規(guī)西醫(yī)療法(SUCRA=79.7%)>補(bǔ)氣方藥(SUCRA=34.1%)>補(bǔ)肝腎方藥(SUCRA=33.6%)>補(bǔ)益氣血方藥(SUCRA=21.7%)>常規(guī)西醫(yī)療法(SUCRA=15.1%)。結(jié)論:目前臨床中預(yù)防膝關(guān)節(jié)置換術(shù)后DVT的常用方藥包括補(bǔ)氣方藥、補(bǔ)益氣血方藥及補(bǔ)肝腎方藥,臨床應(yīng)用時(shí)常聯(lián)合常規(guī)西醫(yī)療法; 補(bǔ)氣方藥聯(lián)合常規(guī)西醫(yī)療法、補(bǔ)益氣血方藥聯(lián)合常規(guī)西醫(yī)療法及補(bǔ)肝腎方藥聯(lián)合常規(guī)西醫(yī)療法預(yù)防膝關(guān)節(jié)置換術(shù)后DVT的效果均優(yōu)于常規(guī)西醫(yī)療法,其中補(bǔ)益氣血方藥聯(lián)合常規(guī)西醫(yī)療法的預(yù)防效果最佳。
Abstract:
Objective:To systematically review the clinical curative effects of Traditional Chinese Medicine(TCM)therapy in preventing deep vein thrombosis(DVT)after the surgery of knee replacement(KR).Methods:All the randomized controlled trial(RCT)articles about TCM therapy for prevention of DVT after KR surgery included from database establishing to October 1,2020 were retrieved from the China National Knowledge Internet,Wanfang Data Knowledge Service Platform,Vip Database,Medline,Cochrane library,Embase and Web of Science through computer.The articles were screened and the information was extracted independently by two researcher.The methodological quality of research in the articles was evaluated and a network meta-analysis was conducted by using Stata14.0 software.Results:Three thousand seven hundred and forty-eight articles were searched out.After screening,59 articles were included in the final analysis,involving conventional western medicine(WM)therapy recommended by Chinese Guidelines for Prevention of Venous Thromboembolism in Major Orthopedic Surgery,Qi-tonics prescriptions combined with conventional WM therapy,Qi-tonics prescriptions,Qi-blood-tonics prescriptions,Qi-blood-tonics prescriptions combined with conventional WM therapy,liver-kidney-tonics prescriptions combined with conventional WM therapy and liver-kidney-tonics prescriptions.The results of network meta-analysis revealed that the efficacies of Qi-tonics prescriptions combined with conventional WM therapy,Qi-blood-tonics prescriptions combined with conventional WM therapy and liver-kidney-tonics prescriptions combined with conventional WM therapy aimed at preventing DVT after KR surgery were better in contrast to conventional WM therapy(RR=0.31,95%CI(0.23,0.43); RR=0.27,95%CI(0.10,0.72); RR=0.31,95%CI(0.14,0.71)); While no statistical differences in the efficacies of the others in preventing DVT after KR surgery were found between the 2 groups.In the 59 RCTs,the efficacies of the 7 interventions for preventing DVT after KR surgery were ranked from best to worst in accordance with surface under the cumulative ranking(SUCRA)values,and the results of SUCRA ranking revealed that Qi-blood-tonics prescriptions combined with conventional WM therapy(SUCRA=84.3%)behaved best in preventing DVT after KR surgery,followed by Qi-tonics prescriptions combined with conventional WM therapy(SUCRA=81.5%),liver-kidney-tonics prescriptions combined with conventional WM therapy(SUCRA=79.7%),Qi-tonics prescriptions(SUCRA=34.1%),liver-kidney-tonics prescriptions(SUCRA=33.6%),Qi-blood-tonics prescriptions(SUCRA=21.7%)and conventional WM therapy(SUCRA=15.1%).Conclusion:The present prescriptions commonly used for preventing DVT after KR surgery in clinic include Qi-tonics prescriptions,Qi-blood-tonics prescriptions and liver-kidney-tonics prescriptions,which are often applied in combination with conventional WM therapy in clinic.The effects of Qi-tonics prescriptions combined with conventional WM therapy,Qi-blood-tonics prescriptions combined with conventional WM therapy and liver-kidney-tonics prescriptions combined with conventional WM therapy in preventing DVT after KR surgery were better in contrast to conventional WM therapy,among which Qi-blood-tonics prescriptions combined with conventional WM therapy behaves best.

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基金項(xiàng)目:浙江省中醫(yī)藥優(yōu)秀青年人才基金項(xiàng)目(2021ZQ047)
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更新日期/Last Update: 2021-12-20