Systematic review and Meta-analysis of flavonoid venoactive drug for the treatment of acute hemorrhoids
Objective:To systematically evaluate the efficacy and safety of flavonoid venoactive drugs in the treatment of acute hemorrhoids in adults.Methods:EMbase,PubMed,the Cochrane Library,CNKI,and WanFang database were searched systematically,and randomized controlled trials(RCTs)related to the efficacy and safety of flavonoid venoactive drugs in the treatment of acute hemorrhoids were included up to December 2023.Meta-analysis was performed using Stata 16.0 software after two 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 6 articles(6 RCTs)were enrolled,including 668 patients.The results of direct comparison Meta-analysis showed that the overall effective rate of flavonoid venoactive drugs combined with the conventional treatment group was significantly better than that of the conventional treatment group[OR =4.86,95%CI(2.86,8.27),P＜0.05].The bleeding improvement rate in the MPFF combined with the conventional treatment group was significantly better than that in the conventional treatment group[OR =3.13,95%CI(2.06,4.77),P＜0.05].Indirect comparison Meta-analysis showed that the total effective rate of MPFF with conventional treatment may be better than that of Diosmin combined with conventional treatment,but the difference was not significant(P＞0.05).SUCRA results showed that the total effective rate of MPFF was the best in the flavonoid venoactive drugs combined with the conventional treatment group(SUCRA =81.7%),followed by the Diosmin combined with the conventional treatment group(SUCRA =68.2%),both of which were significantly better than the conventional treatment group(SUCRA =0.1%).The incidence of adverse events of flavonoid venoactive drugs was comparable to that of the conventional treatment group.Conclusion:Existing evidence suggests that flavonoid venoactive drugs are safe and effective in the treatment of acute hemorrhoids,and the MPFF may be more effective.However,due to the limitations of the number and sample size,the above conclusions still need to be verified by more large-sample multi-center clinical trials.
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