中医治疗非哺乳期乳腺炎术后创面的疗效评价及其Meta分析

Meta-analysis of the curative efficacy on the therapy of traditional Chinese medicine on postoperative wound repair in patients with non-puerperal mastitis

目的采用系统评价与Meta分析的方法,探讨中医治疗对非哺乳期乳腺炎(Non-puerperal mastitis,NPM)术后创面的临床疗效以及相关机制。方法在中国知网(CNKI)、万方数据知识服务平台(Wanfang)、维普中文期刊数据库(VIP)、PubMed、Embase、Cochrane Library等数据库中全面检索在手术治疗基础上应用中医疗法干预非哺乳期乳腺炎疗效的临床随机对照试验,检索时间为建库日至2022年3月。进行文献阅读、筛选、信息提取,对纳入文献进行系统评价,采用RevMan 5.3软件进行Meta分析。结果系统评价与Meta分析最终纳入文献17篇。其种15篇文献报道了有效率,5篇文献报道了半年复发率,5篇文献报道了1年复发率,7篇文献报道了临床疗效相关机制。Meta分析结果显示,手术治疗联合中医疗法组(观察组)有效率94.12%,显著高于单纯手术组(对照组)的73.39%(P<0.01);观察组半年复发率为12.00%,显著低于对照组42.26%(P<0.01);观察组1年复发率5.65%,显著低于对照组22.52%(P<0.01);观察组干预措施能更显著地降低非哺乳期乳腺炎患者外周血C反应蛋白(C-reactive protein,CRP)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor,TNF-α)、免疫球蛋白A(Immunoglobulin A,IgA)、免疫球蛋白G(Immunoglobulin G,IgG)水平。结论中医疗法与手术联合治疗NPM,创面修复明显优于单纯手术治疗,且术后复发率明显降低。

Objective To study the clinical efficacy and related mechanism of traditional Chinese medicine on wound repair after surgery of non-puerperal mastitis(NPM) using systematic review and meta-analysis. Methods All of the clinical randomized controlled trials on traditional Chinese medicine combined with surgery in the treatment of NPM were searched from databases of CNKI, Wanfang, VIP, PubMed, Embase and Cochrane Library from the inception of the databases to March2022. Literature reading, screening and information extraction were carried out, and the included literature was systematically evaluated. Revman 5.3 software was used for meta-analysis. Results A total of 17 literatures were finally included in the systematic review and meta-analysis. The effective rate was reported in 15 literatures, the recurrence rate in half a year was reported in 5 literatures, the recurrence rate in one year was reported in 5 literatures and the mechanism of clinical efficacy was reported in 7 literatures. The results of meta-analysis showed that the effective rate of traditional Chinese medicine combined with surgery(observed group) was 94.12%, which was significantly higher than 73.39% of simple surgery(control group, P<0.01). The half year recurrence rate in the observed group was 12.00%, which was significantly lower than 42.26%in the control group(P<0.01). The one-year recurrence rate in the observed group was 5.65%, which was significantly lower than 22.52% in the control group(P<0.01). The intervention measures in the observation group can significantly reduce the level of CRP, IL-6, TNF-α, IgA and IgG in peripheral blood of patients with non-puerperal mastitis. Conclusion The effective rate and recurrence rate of traditional Chinese medicine combined with surgery in the treatment of NPM were better than that of simple therapy of surgery.