中药熏洗治疗踝关节扭伤的Meta分析

Meta-analysis of Chinese Herbal Fumigation for Ankle Sprain

目的评价中药熏洗治疗踝关节扭伤的临床疗效。方法检索中国知网、万方数据库、中文科技期刊数据库(维普)、中国生物文献数据库(CBM)、PubMed、CochraneLibrary数据库内中药熏洗治疗踝关节扭伤的随机对照实验,提取其中数据,利用Cochrane评价系统对纳入文献进行质量评价,并通过RevMan5.3软件对数据进行Meta分析。结果共纳入20篇文献,受试者1779例。Meta分析结果显示:与对照组相比,中药熏洗可以提高踝关节扭伤的总有效率[RR=1.19,95%CI(1.14,1.24),P<0.00001],降低踝关节扭伤患者视觉模拟量表(VAS)评分[MD=-0.97,95%CI(-1.05,-0.45),P=0.0003],提高踝关节扭伤患者的临床Kofoed踝关节功能评分[MD=7.34,95%CI(2.51,12.17),P=0.003]、Mazur踝关节评分优良率[RR=1.22,95%CI(1.10,1.35),P=0.0002],以及临床AOFAS踝-后足评分[MD=10.25,95%CI(4.12,16.38),P=0.001]。纳入文献经漏斗图分析及Egger′s线性回归法检验分析(t=2.56,P=0.022<0.050),提示可能存在发表偏倚。结论中药熏洗治疗踝关节扭伤临床疗效确切,可以缓解疼痛,改善踝关节功能。

Objective:To evaluate the clinical efficacy of Chinese herbal fumigation for ankle sprain.Methods:Randomized controlled trials(RCTs)on the treatment of ankle sprain with Chinese herbal fumigation were retrieved from CNKI,Wanfang,VIP,CBM,PubMed and Cochrane Library databases,and the data were extracted.Cochrane evaluation system was used to evaluate the quality of the included literatures,and RevMan5.3 software was used to perform meta-analysis on the data.Results:A total of 20 literatures were included,including 1779 subjects.Meta-analysis results showed that compared with the control group,traditional Chinese medicine(TCM)fumigation and washing could improve the total effective rate of ankle sprain[RR=1.19,95%CI(1.14,1.24),P<0.00001],and reduce the VAS score of patients with ankle sprain[MD=-0.97,95%CI(-1.05,-0.45),P=0.0003],improve the clinical Kofoed ankle function score[MD=7.34,95%CI(2*51,12*17),P=0.003],the excellent rate of Mazur ankle joint score[RR=1.22,95%CI(1.10,1.35),P=0.0002]and clinical AOFAS ankle-posterior foot score[MD=10.25,95%CI(4.12,16.38),P=0.001].The included literatures were analyzed by funnel plot and Egger's linear regression method(i=2.56,P=0.022),which suggested publication bias.Conclusion:TCM fumigation and washing is effective in the treatment of ankle sprain,which can relieve pain and improve ankle function.