桃红四物汤加减辅助治疗外伤性骨折临床疗效和安全性的系统评价
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篇名: 桃红四物汤加减辅助治疗外伤性骨折临床疗效和安全性的系统评价
TITLE:
摘要: 目的:系统评价桃红四物汤加减辅助治疗外伤性骨折的疗效和安全性,为临床提供循证参考。方法:计算机检索中国期刊全文数据库、中国生物医学文献数据库、万方数据库和PubMed,收集骨折整复后联合桃红四物汤加减(试验组)对比单纯骨折整复(对照组)治疗外伤性骨折的相关研究,提取资料并参考Cochrane协作网推荐的方法评价质量后,采用Rev Man 5.3统计软件进行Meta分析。结果:共纳入6项随机对照试验和3项临床对照研究,合计929例患者。Meta分析结果显示,试验组患者临床总有效率[RR=1.35,95%Cl(1.24,1.47),P<0.001]和胃肠道不良反应发生率[RR=5.59,95%Cl(1.30,24.14),P=0.02]显著高于对照组,症状体征积分[MD=-5.50,95%Cl(-6.45,-4.54),P<0.001]、红细胞沉降率[MD=-13.78,95%Cl(-15.97,-11.60),P<0.01]、全血黏度[MD=-1.03,95%Cl(-1.11,-0.95),P<0.001]、血浆黏度[MD=-0.24,95%Cl(-0.27,-0.21),P<0.01]、血细胞比容[MD=-12.12,95%Cl(-13.37,-10.86),P<0.01]和红细胞电泳时间[MD=-7.12,95%Cl(-7.88,-6.35),P<0.01]显著低于对照组,差异均有统计学意义。结论:桃红四物汤加减辅助治疗外伤性骨折可提高临床疗效,降低患者炎症反应,改善血液流变学,但会加重患者胃肠道反应。
ABSTRACT: OBJECTIVE: To systematically review the therapeutic efficacy and safety of modified Taohong siwu decoction in adjuvant therapy of traumatic fracture, and to provide evidence-based reference in clinic. METHODS: Retrieved from CJFD, CBM, Wanfang database and PubMed, related studies about fracture restitution combined with modified Taohong siwu decoction (trial group) vs. fracture restitution alone (control group) in the treatment of traumatic fracture were collected. Meta-analysis was conducted by using Rev Man 5.3 statistical software after data extraction and quality evaluation according to Cochrane systematic review. RESULTS: A total of 6 RCTs and 3 clinical control trials were included, involving 929 patients. Meta-analysis showed that clinical total response rate [RR=1.35,95%Cl(1.24,1.47),P<0.001] and the incidence of gastrointestinal ADR [RR=5.59,95%Cl(1.30,24.14),P=0.02] in trial group were significantly higher than control group; symptom and sign score [MD=-5.50,95%Cl(-6.45,-4.54),P<0.001], erythrocyte sedimentation [MD=-13.78,95%Cl(-15.97,-11.60),P<0.01], whole blood viscosity [MD=-1.03,95%Cl(-1.11,-0.95),P<0.001], plasma viscosity [MD=-0.24,95%Cl(-0.27,-0.21),P<0.01], hematocrit [MD=-12.12,95%Cl(-13.37,-10.86),P<0.01] and erythrocyte electrophoresis time [MD=-7.12,95%Cl(-7.88,-6.35),P<0.01] of trial group were significantly lower than those of control group, with statistical significance. CONCLUSIONS: For adjunctive therapy of traumatic fracture, modified Taohong siwu decoction can improve clinical efficacy, reduce the inflammatory reaction, improve blood rheology but aggravate gastrointestinal reaction.
期刊: 2017年第28卷第36期
作者: 王晓彤,林海雄,肖志勋,黄冬欢,金远林,黄枫
AUTHORS: WANG Xiaotong,LIN Haixiong,XIAO Zhixun,HUANG Donghuan,JIN Yuanlin,HUANG Feng
关键字: 桃红四物汤加减;骨折整复;外伤性骨折;Meta分析;疗效;安全性
KEYWORDS: Modified Taohong siwu decoction; Fracture restitution; Traumatic fracture; Meta-analysis;Therapeutic efficacy;Safety
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