[1]孟 涛,韩金昌,李付元,等.基于GRADE评级对活血利水类中药复方治疗全膝关节置换术后膝关节肿痛的Meta分析[J].医学信息,2023,36(09):109-116.[doi:10.3969/j.issn.1006-1959.2023.09.022]
 MENG Tao,HAN Jin-chang,LI Fu-yuan,et al.Meta-analysis of Traditional Chinese Medicine Compound for Huoxue Lishui Chinese Herbal Compound in the Treatment of Knee Joint Swelling and Pain After Total Knee Arthroplasty Based on GRADE Rating[J].Journal of Medical Information,2023,36(09):109-116.[doi:10.3969/j.issn.1006-1959.2023.09.022]
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基于GRADE评级对活血利水类中药复方治疗全膝关节置换术后膝关节肿痛的Meta分析()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
36卷
期数:
2023年09期
页码:
109-116
栏目:
论著
出版日期:
2023-05-01

文章信息/Info

Title:
Meta-analysis of Traditional Chinese Medicine Compound for Huoxue Lishui Chinese Herbal Compound in the Treatment of Knee Joint Swelling and Pain After Total Knee Arthroplasty Based on GRADE Rating
文章编号:
1006-1959(2023)09-0109-08
作者:
孟 涛韩金昌李付元
(天津中医药大学第一附属医院骨伤科/国家中医针灸临床医学研究中心/国家中医药管理局区域中医骨伤科诊疗中心,天津 300381)
Author(s):
MENG TaoHAN Jin-changLI Fu-yuanet al.
(Department of Orthopedics and Traumatology,First Teaching Hospital of Tianjin University of Traditional Chinese Medicine/National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion/ Regional Orthopaedics and Traumatology Diagnosis and Treatment Center,National Administration of Traditional Chinese Medicine,Tianjin 300381,China)
关键词:
全膝关节置换中药肿胀疼痛
Keywords:
Total knee arthroplastyHuoxue Lishui Chinese medicine compoundSwellingPain
分类号:
R274.9
DOI:
10.3969/j.issn.1006-1959.2023.09.022
文献标志码:
A
摘要:
目的 通过Meta分析的方法归纳合并结局指标,系统评价口服活血利水类中药复方对全膝关节置换(TKA)术后膝关节肿胀、疼痛的临床疗效,并对相关证据进行质量等级评价,旨在为临床提供更有力的循证依据。方法 检索建库至2021年12月数据库(中国知网、万方、维普、中国生物医学文献数据库、PubMed、EMbase、Cochrane Library、Web of Science)中活血利水类中药复方治疗TKA术后膝关节肿胀、疼痛的随机对照试验(RCTs),提取筛选出的文献数据,采用Cochrane偏倚风险评估工具对文献进行质量评价,采用ReviewManager5.4软件对膝关节肿胀度进行Meta分析,对结局指标以漏斗图表示发表偏倚,按照GRADE标准对结局指标进行证据质量评价。结果 共纳入病例632例,其中治疗组共纳入324例,对照组共纳入308例。Meta分析结果显示,与对照组比较,治疗组在降低VAS评分[SMD=-1.13,95%CI(-1.60,-0.67),P<0.000 01]、降低膝关节肿胀度[SMD=-0.62,95%CI(-1.05,-0.20),P=0.004]方面具有优势。上述2项结局指标发表偏倚结果提示,VAS评分和膝关节肿胀度的纳入文献可能存在潜在的发表偏倚。结论 口服活血利水类中药复方治疗TKA术后肿胀、疼痛有明显临床疗效。
Abstract:
Objective To systematically evaluate the clinical efficacy of Chinese medicine compound for huoxue lishui chinese herbal compound in the treatment of knee joint swelling and pain after total knee arthroplasty (TKA) by summarizing the combined outcome indicators through Meta-analysis, and to evaluate the quality grade of relevant evidence, aiming to provide a more powerful evidence-based basis for clinical practice.Methods The randomized controlled trials (RCTs) on the treatment of knee joint swelling and pain after TKA by traditional Chinese medicine compounds for promoting blood circulation and diuresis in the database (China National Knowledge Infrastructure, Wanfang, VIP, China Biomedical Literature Database, PubMed, EMbase, Cochrane Library, Web of Science) from the establishment of the database to December 2021 were retrieved. The selected literature data were extracted and the quality of the literature was evaluated by Cochrane bias risk assessment tool. Meta-analysis of knee joint swelling was performed using ReviewManager 5.4 software. Funnel plot was used to represent publication bias. The quality of evidence was evaluated according to GRADE criteria.Results A total of 632 cases were included, including 324 cases in the treatment group and 308 cases in the control group. The results of Meta-analysis showed that compared with the control group, the treatment group had advantages in reducing VAS score [SMD=-1.13,95%CI(-1.60,-0.67),P<0.000 01] and reducing knee joint swelling [SMD=-0.62,95%CI(-1.05,-0.20),P=0.004]. The publication bias results of the above two outcome indicators suggest that there may be potential publication bias in the included literature of VAS score and knee swelling.Conclusion Oral Huoxue Lishui Chinese medicine compound has obvious clinical effect in the treatment of swelling and pain after TKA.

参考文献/References:

[1]王燎,江旭,韩学全,等.3D打印个体化导板辅助胫骨高位截骨1例报道[J].中华骨与关节外科杂志,2019,12(1):58-61.[2]中华医学会骨科学分会关节外科学组,中国医师协会骨科医师分会骨关节炎学组,湘雅医院国家老年疾病临床医学研究中心,等.中国骨关节炎诊疗指南(2021年版)[J].中华骨科杂志,2021,41(18):1291-1314.[3]周宗科,翁习生,曲铁兵,等.中国髋、膝关节置换术加速康复——围术期管理策略专家共识[J].中华骨与关节外科杂志,2016,9(1):1-9.[4]王禹增.“血不利则为水”的学术思想在骨科的应用[J].中医药通报,2014,13(2):14-15.[5]白海玉,张树明.中药成方制剂剂型应用分析[J].中国中医药科技,2021,28(6):906-908.[6]周凯,张焱,朱明双.补阳还五汤防治全膝置换术后肿痛疗效观察[J].实用中医药杂志,2015,31(4):282-283.[7]王勇刚,尚荣安.肿痛消方治疗全膝关节置换术后肿痛的疗效观察[J].陕西中医,2016,37(5):543-544.[8]张志权,卢明峰,胡广兵,等.桂枝茯苓丸对全膝关节置换术后伤口红肿热痛的影响[J].河南中医,2018,38(3):346-349.[9]张德生,董芳,孙永强.益气运脾法治疗全膝关节置换术后肿胀临床观察[J].中医学报,2018,33(3):395-399.[10]彭弗里曼,肖学锋.自拟毛冬青汤治疗全膝关节置换术后膝关节肿胀39例临床观察[J].湖南中医杂志,2018,34(9):74-75.[11]詹洋,李炜明,陈玲,等.丹七牛仁八珍汤治疗老年全膝关节置换术后肿痛的临床研究[J].实用中西医结合临床,2019,19(6):92-94.[12]林妙阔,黄露露,朱亚菊,等.四物镇痛汤联合主被动锻炼对全膝关节置换术后早期膝关节功能康复的疗效观察[J].中国老年学杂志,2020,40(14):3010-3013.[13]张春啸,孙艳凤,严彬,等.丹参活血汤联合电疗治疗自发性膝关节骨坏死微创置换术后肿胀疼痛的效果[J].中国中西医结合外科杂志,2021,27(1):91-95.[14]黄思聪,刘学东,王艺钦,等.益气活血中药联合运动疗法对全膝关节置换术后疗效影响的研究[J].按摩与康复医学,2021,12(9):15-17.[15]Guyatt GH,Oxman AD,Montori V,et al.GRADE guidelines: 5. Rating the quality of evidence--publication bias[J].J Clin Epidemiol,2011,64(12):1277-1282.[16]卢庆威,王军,王刚,等.桃核承气汤在防治下肢深静脉血栓形成中的临床疗效研究[J].时珍国医国药,2021,32(8):1927-1930.[17]林俊杰,梁冠璧,毛炜.张仲景“血不利则为水”与活血化瘀治疗水肿[J].实用中医内科杂志,2013,27(7):94-95.[18]朱毅.浅析“血不利则为水”在伤科肿胀治疗中的指导意义[J].中国中医骨伤科杂志,2012,20(12):65-66.[19]田伟.中国骨科大手术静脉血栓栓塞症预防指南[J].中华骨科杂志,2016,36(2):65-71.[20]崔超毅,张荣,宋菊民,等.腹部外科病人术后症状性静脉血栓栓塞症中心临床流行病学研究[J].中国实用外科杂志,2020,40(5):547-550,556.[21]戎毅,於浩,杨俊锋,等.老年髋部骨折患者术后并发下肢深静脉血栓的危险因素分析及风险预测[J].中国组织工程研究,2022,26(33):5357-5363.[22]李宇宏,索芳芳.生肌玉红膏联合活血化瘀中药离子导入对糖尿病足患者足部血流、创面愈合的影响[J].中西医结合研究,2021,13(2):85-88.[23]陆智昇,徐鹏,胡天祥,等.从水通道蛋白角度探讨活血利水法治疗急性肾损伤的内在机制[J].中医杂志,2022,63(5):430-434.[24]刘雷蕾,马淑然.基于脑-肠轴探讨脾主运化水液应长夏而变的物质基础与科学内涵[J].辽宁中医杂志,2020,47(9):43-45.[25]李慧君,郭爽,王天合,等.茯苓利下焦水湿有效物质部位的筛选及其作用机制研究[J].中国医院药学杂志,2022,42(5):519-524.

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更新日期/Last Update: 1900-01-01