静脉活性药物治疗痔术后并发症的系统评价和网状Meta分析
Systematic review and network Meta-analysis of venoactive drug for the treatment of hemorrhoidectomy complications
张田 1李婷 1赵紫楠 1王洋 1金鹏飞1
作者信息
- 1. 北京医院药学部/国家老年医学中心/中国医学科学院老年医学研究院/北京市药物临床风险与个体化应用评价重点实验室(北京医院),北京 100730
- 折叠
摘要
目的:系统评价不同静脉活性药物治疗痔术后并发症的疗效.方法:计算机检索 Embase、PubMed、The Cochrane Library、中国知网、万方数据库等文献资料,筛选包含静脉活性药物治疗痔术后并发症的随机对照试验(randomized controlled trial,RCT),检索时间从建库截至2023 年12 月.由2 名研究者按照纳入与排除标准筛选文献、提取资料并评价纳入研究的方法学质量后,应用Stata 16.0 软件,利用传统Meta分析和网状Meta分析方法对纳入的RCT研究结果进行合并.结果:共纳入22 项RCT研究,包含2743 例患者.传统Meta分析和网状Meta分析均显示联合使用静脉活性药物可显著降低患者术后并发症发生率,缩短并发症持续时间,改善并发症评分,促进伤口愈合,差异有统计学意义(P＜0.05).网状Meta分析结果显示纯化微粒化黄酮在改善术后出血评分、缩短术后出血时间方面疗效最佳;地奥司明在降低术后水肿率和出血率方面疗效最佳;七叶皂苷类药物在缩短术后伤口愈合时间和改善术后并发症总有效率方面最佳;香豆素类药物在缩短术后疼痛时间和水肿时间、降低术后疼痛评分和水肿评分方面疗效最佳.结论:静脉活性药物在痔术后并发症中的疗效良好,不同类型静脉活性药物的改善效果可能各不相同.但受纳入研究数量和研究质量的限制,上述结论尚需要更多大样本多中心高质量的临床试验予以验证.
Abstract
Objective:To systematically evaluate the efficacy of different venoactive drugs in the treatment of hemorrhoidectomy complications.Methods:EMbase,PubMed,The Cochrane Library,CNKI,and WanFang database were searched systematically,and randomized controlled trials(RCTs)related to the efficacy of venoactive drugs in the treatment of hemorrhoidectomy complications were included up to December 2023.Meta-analysis and network Meta-analysis were performed using Stata 16.0 software after 2 researchers screened the literature according to inclusion and exclusion criteria,extracted data,and evaluated the methodological quality of the included studies.Results:A total of 22 articles(6 RCTs)were enrolled,including 2 743 patients.The results of the traditional Meta-analysis and network Meta-analysis showed that the venoactive drugs combined with the conventional treatment group could significantly reduce the incidence of postoperative complications,shorten the duration of complications,improve complication scores,and promote wound healing,with statistical significance(P＜0.05).Network Meta-analysis showed that MPFF was the most effective in improving postoperative bleeding score and shortening postoperative bleeding time.Diosmin has the best effect in reducing postoperative edema rate and bleeding rate.Aesculus was the best in shortening wound healing time and improving the total effective rate of postoperative complications.Coumarins have the best effect on shortening postoperative pain and edema time,reducing postoperative pain and edema score.Conclusion:Existing evidence suggests that venoactive drugs are effective in the treatment of hemorrhoidectomy complications,and each venoactive drug has distinct benefits in complications.However,due to the limitations of the number and quality of included studies,the above conclusions still need to be verified by more large-sample multi-center clinical trials.
关键词
静脉活性药物/系统评价/Meta分析/随机对照试验Key words
venoactive drug/systematic review/Meta-analysis/randomized controlled trials引用本文复制引用
基金项目
国家卫生健康委员会医药卫生科研专项资金资助项目(WKZX2023CX210007)
出版年
2024
NETL
NSTL
万方数据