血府逐瘀方预防骨科大手术后深静脉血栓形成临床疗效的Meta分析

Clinical Efficacy of Xuefu Zhuyu Decoction in Preventing Deep Vein Thrombosis after Major Orthopedic Surgery:a Meta-analysis

目的系统评价血府逐瘀方(包括汤剂、胶囊、丸剂、片剂、颗粒剂)联合常规西药预防骨科术后深静脉血栓形成的临床疗效,为临床提供循证依据。方法系统检索知网、万方、维普、CBM、PubMed、Cochrane library等数据库,纳入血府逐瘀方联合常规西药预防骨科术后深静脉血栓形成的临床研究,提取相关数据并进行方法质量评估,利用RevMan5.3软件进行Meta分析。结果本研究纳入8篇临床研究,共计665例患者,血府逐瘀方联合常规西药组334例,单纯使用常规西药组331例。Meta分析结论示:血府逐瘀方联合常规西药组深静脉血栓形成发生率明显低于常规西药组[OR=0.29,95%CI(0.17,0.49),P<0.00001],差异具有统计学意义;术后D-二聚体比较,血府逐瘀方联合常规西药组低于常规西药组[SMD=-1.55,95%CI(-2.40,-0.70),P=0.0004],差异具有统计学意义;纤维蛋白比较,血府逐瘀方联合常规西药组低于常规西药组[MD=-0.41,95%CI(-0.64,-0.18),P=0.0004],差异具有统计学意义;凝血酶原时间比较,血府逐瘀方联合常规西药组优于常规西药组[MD=0.24,95%CI(0.10,0.37),P=0.0007],差异具有统计学意义;活化部分凝血活酶时间比较,血府逐瘀方联合常规西药组优于常规西药组[MD=3.6,95%CI(0.59,6.6),P=0.02],差异具有统计学意义。结论与单纯常规西药相比,血府逐瘀方联合常规西药能够更加有效预防骨科术后深静脉血栓形成,具有一定的临床应用价值。

Objective:To systematically evaluate the clinical efficacy of Xuefu Zhuyu Decoction(including soups,capsules,pills,tablets,granules)combined with conventional western medicine to prevent deep vein thrombosis after orthopedic surgery and to provide evidence-based evidence for the clinic.Methods:Databases such as CNKI,Wanfang,VIP,CBM,PubMed and Cochrane library were systematically searched,and the clinical studies of Xuefu Zhuyu Decoction combined with conventional western medicine to prevent deep vein thrombosis after orthopedics were included.Meta-analysis was conducted using RevMan5.3 software.Results:8 studies were included,with a total of 665 patients;334 cases in the Xuefu Zhuyu Decoction combined with conventional western medicine group,and 331 cases in the conventional western medicine only group.Meta-analysis results showed that the incidence of deep vein thrombosis in Xuefu Zhuyu Decoction combined with conventional western medicine group was significantly lower than that in conventional western medicine group[OR=0.29,95%CI(0.17,0.49),P<0.00001],the difference was statistically significant;in postoperative D-dimer,Xuefu Zhuyu Decoction combined with conventional western medicine group was lower than conventional western medicine group[SMD=-1.55,95%CI(-2.40,-0.70),P=0.0004],the difference was statistically significant;in fibrin,Xuefu Zhuyu Decoction combined with conventional western medicine group was lower than conventional western medicine group[MD=-0.41,95%CI(-0.64,-0.18),P=0.0004],the difference was statistically significant;in prothrombin time,Xuefu Zhuyu Decoction combined with conventional western medicine group was superior to conventional western medicine group[MD=0.24,95%CI(0.10,0.37),P=0.0007],the difference was statistically significant;in activated partial thromboplastintime,Xuefu Zhuyu Decoction combined with conventional western medicine group was superior to conventionalwestern medicine group[MD=3.6,95%CI(0.59,6.6),P=0.02],the difference was statistically significant.Conclusion:Compared with the conventional western medicine group,Xuefu Zhuyu Decoction combined with the conven-tional western medicine group can prevent deep vein thrombosis after orthopedic surgery more effectively and hascertain clinical application value.