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[1]孟祥亞,馬士超,陳秀民.補陽還五湯預防全髖關節(jié)置換術后深靜脈血栓形成有效性和安全性的mETA分析[J].中醫(yī)正骨,2023,35(11):37-43.
　MENG Xiangya,MA Shichao,CHEN Xiumin.Clinical outcomes and safety of Buyang Huanwu Tang(補陽還五湯)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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補陽還五湯預防全髖關節(jié)置換術后深靜脈血栓形成有效性和安全性的mETA分析()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第35卷
期數(shù):
2023年11期
頁碼:
37-43
欄目:
文獻研究
出版日期:
2023-11-20

文章信息/Info

Title:
Clinical outcomes and safety of Buyang Huanwu Tang(補陽還五湯)for prevention of deep vein thrombosis after total hip arthroplasty:a meta-analysis
作者:
孟祥亞1; 馬士超2; 陳秀民2
1.河南中醫(yī)藥大學骨傷學院,河南 鄭州 450002; 2.濮陽市中醫(yī)醫(yī)院,河南 濮陽 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
關鍵詞:
補陽還五湯;  關節(jié)成形術; 置換; 髖;  靜脈血栓形成;  專題Meta分析
Keywords:
Buyang Huanwu Tang;  arthroplasty; replacement; hip;  venous thrombosis;  meta-analysis as topic
摘要:
目的:系統(tǒng)評價補陽還五湯預防全髖關節(jié)置換術后深靜脈血栓形成(deep vein thrombosis,DVT)的有效性和安全性。方法:應用計算機檢索中國知網(wǎng)、萬方數(shù)據(jù)庫、維普網(wǎng)、中國生物醫(yī)學文獻服務系統(tǒng)、PubMed、Cochrane Library、Embase、Web of Science,篩選補陽還五湯預防全髖關節(jié)置換術后DVT的隨機對照試驗,檢索時限均為建庫至2023年9月。試驗組采用補陽還五湯治療或補陽還五湯聯(lián)合抗凝藥物治療,對照組采用抗凝藥物治療。由2名研究人員獨立篩選文獻、提取數(shù)據(jù)并評價納入研究的偏倚風險后,采用RevMan5.4軟件進行Meta分析。結果:共納入16項研究,涉及1445例患者,其中試驗組726例、對照組719例。Meta分析結果顯示,術后第7天和術后第14天時,試驗組的DVT發(fā)生率、血漿D-二聚體水平、血漿纖維蛋白原水平均低于對照組[術后第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; 術后第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]; 試驗組的不良反應發(fā)生率低于對照組[RR=0.58,95%CI(0.42,0.81),P=0.001]。基于DVT發(fā)生率的漏斗圖不對稱,提示存在發(fā)表偏倚的可能。結論:與單獨使用抗凝藥物相比,全髖關節(jié)置換術后單獨使用補陽還五湯或聯(lián)合應用抗凝藥物能更好地降低DVT發(fā)生率、血漿D-二聚體水平及血漿纖維蛋白原水平,而且安全性更高。
Abstract:
Objective:To systematically review the clinical outcomes and safety of Buyang Huanwu Tang(補陽還五湯,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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備注/Memo

備注/Memo:
基金項目:河南省中醫(yī)藥科學研究專項課題(2022ZY1192)
通訊作者:陳秀民 E-mail:[email protected]
更新日期/Last Update: 1900-01-01