中药复方治疗股骨头坏死的临床疗效及血液流变学影响的Meta分析
Meta-analysis of the clinical efficacy and hemorheological effects of Chinese herbal compound in the treatment of femoral head necrosis
刘茂立 1任俊筱 1谢元洋 1徐天利 1顾海潮2
作者信息
- 1. 云南中医药大学第一临床医学院,昆明 650500
- 2. 云南中医药大学第一附属医院,昆明 650021
- 折叠
摘要
目的 系统评价中药复方治疗股骨头坏死的疗效及血液流变学影响,以期为临床治疗提供循证参考.方法 系统检索PubMed、Cochrane Library、中国生物医学文献数据库(CBM)、中国知网数据库(CNKI)、万方医学数据库(WanFang)、维普数据库(VIP)共6个数据库,检索时间为数据库建库至2024年3月14日,按照拟定的纳入标准与排除标准进行筛选,按照Cochrane偏倚风险评价工具对文献进行质量评价,采用RevMan 5.3软件进行Meta分析.结果 共检索到文献1 017篇,筛选后纳入文献10篇,共包括患者878例.Meta分析结果显示,干预组临床有效率优于对照组[RR=1.24,95%CI(1.16,1.33),P＜0.000 01];干预组治疗后Harris评分高于对照组[MD=5.74,95%CI(5.59,5.89),P＜0.000 01];干预组治疗后视觉模拟评分法(VAS)评分低于对照组[MD=-1.53,95%CI(-2.05,-1.01),P＜0.000 01];干预组治疗后全血高切黏度低于对照组[SMD=-1.85,95%CI(-2.77,-0.92),P＜0.000 1];干预组治疗后全血低切黏度低于对照组[SMD=-2.38,95%CI(-3.24,-1.52),P＜0.000 01];干预组治疗后血浆黏度低于对照组[SMD=-0.68,95%CI(-0.92,-0.44),P＜0.000 01];干预组治疗后红细胞聚集指数低于对照组[SMD=-4.46,95%CI(-7.24,-1.69),P=0.002].结论 与单纯西医治疗相比,中药复方联合西医治疗股骨头坏死在临床有效率及改善血液流变学指标方面有一定优势,但尚需大样本、多中心、双盲的随机对照试验证据支持.
Abstract
Objective To systematic evaluate the efficacy and hemorheological effects of Chinese herbal compound in the treatment of femoral head necrosis,in order to provide evidence-based reference for clinical treatment.Methods Six databases including PubMed,Cochrane Library,Chinese Biomedical Literature Database(CBM),China Knowledge Network Database(CNKI),WanFang Medical Database(WanFang)and VIP Database(VIP)were systematically searched.The retrieval time was from the establishment of the databases until March 14,2024.Screening was performed according to the proposed inclusion criteria and exclusion criteria.The quality of the literature was evaluated according to the Cochrane bias risk assessment tool.RevMan 5.3 software was used for Meta-analysis.Results A total of 1 017 articles were retrieved,and 10 articles were included after screening,including a total of 878 patients.The results of Meta-analysis showed that the clinical effective rate of the intervention group was better than that of the control group[RR=1.24,95%CI(1.16,1.33),P<0.000 01].After treatment,the Harris score of the intervention group was higher than that of the control group[MD=5.74,95%CI(5.59,5.89),P<0.000 01].After treatment,the visual analogue scale(VAS)score of the intervention group was lower than that of the control group[MD=-1.53,95%CI(-2.05,-1.01),P<0.000 01].After treatment,the whole blood high shear viscosity in the intervention group was lower than that in the control group[SMD=-1.85,95%CI(-2.77,-0.92),P<0.000 1].After treatment,the whole blood low shear viscosity in the intervention group was lower than that in the control group[SMD=-2.38,95%CI(-3.24,-1.52),P<0.000 01].The plasma viscosity of the intervention group was lower than that of the control group after treatment[SMD=-0.68,95%CI(-0.92,-0.44),P<0.000 01].The erythrocyte aggregation index after treatment in the intervention group was lower than that in the control group[SMD=-4.46,95%CI(-7.24,-1.69),P=0.002].Conclusion Compared with western medicine alone,Chinese herbal compound combined with western medicine in the treatment of femoral head necrosis has certain advantages in clinical efficiency and improvement of hemorheological indexes,but it still needs to be supported by large sample,multi-center,double-blind randomized controlled trial evidence.
关键词
股骨头坏死/中药复方/血液流变学/系统评价/随机对照试验/Meta分析Key words
Femoral head necrosis/Chinese herbal compound/Hemorheology/System evaluation/Randomized controlled trial/Meta-analysis引用本文复制引用
出版年
2024
NETL
NSTL
万方数据