穴位贴敷预防骨科患者术后静脉血栓形成的Meta分析

Meta analysis of acupoint application in preventing postoperative venous thrombosis in orthopaedic patients

目的 针对骨科手术后的患者应用穴位贴敷,评价对血栓疾病的治疗效果。方法 针对穴位贴敷预防骨科患者术后静脉血栓疾病运用计算机检索的方式开展试验,主要为随机对照试验(RCT),包括The Cochrane Library和中国知网,还有Pub Med和万方以及Web Of Science和EMbase、维普等。对文献与数据进行提取,并对文献资料的质量进行评价,用Rev Man5.4软件进行分析,比较静脉血栓发生率、凝血酶原时间、活化部分凝血活酶时间等。结果 合计纳入13篇中文文献,共有1 206例研究对象。Meta分析结果显示,穴位贴敷能改善DVT发生率[OR=0.21,95%CI:(0.12,0.35),P <0.000 01],PT[SMD=2.77,95%CI:(0.81,4.74),P <0.05],APTT[SMD=6.79,95%CI:(1.21,12.38),P <0.05],TT[SMD=2.65,95%CI:(1.83,3.47),P <0.000 01], D-dimer[SMD=-0.29,95%CI:(-0.40,-0.17),P <0.000 01]水平。结论 针对术后易出现静脉血栓的患者,运用穴位贴敷具有一定的预防作用,但是,相关证据质量的水平并不高,因此,在疗效进行验证的过程中,需要运用质量较高的RCT临床试验完成验证的工作。

Objective To systematically evaluate the effect of acupoint application on the prevention of postoperative venous thrombosis in orthopaedic patients. Methods The randomized controlled trial(RCT) of acupoint application for the prevention of postoperative venous thrombosis in orthopaedic patients was searched by computer in the databases of the Cochrane Library, PubMed, web of science, EMBASE, sinomed, CNKI, Wanfang and VIP. The literature and data were extracted, and the quality of the literature was evaluated. RevMan5.4 software was used to analyze the incidence of venous thrombosis, prothrombin time, activated partial thromboplastin time, etc.Results A total of 13 Chinese literatures were included, including 1 206 subjects. Meta analysis showed that acupoint application could improve the incidence of DVT [OR = 0.21, 95% CI:(0.12,0.35), P < 0.000 01], PT [SMD = 2.77, 95% CI:(0.81,4.74), P < 0.05], APTT [SMD = 6.79, 95%CI:(1.21,12.38), P < 0.05], TT [SMD = 2.65, 95%CI:(1.83,3.47), P < 0.000 01], D-dimer [SMD=-0.29, 95%CI:(-0.40,-0.17), P < 0.000 01]. Conclusion Acupoint application can prevent postoperative venous thrombosis.However, the credibility of relevant evidence needs to be further improved, and high-quality RCT clinical trials are still needed to further verify and analyze its curative effect.