Inner Mongolia Medical University, Hohhot, Inner Mongolia 010110.
Inner Mongolia Institute of Traditional Chinese and Mongolian Medicine, Hohhot, Inner Mongolia 010010.
Phytomedicine. 2022 Sep;104:154244. doi: 10.1016/j.phymed.2022.154244. Epub 2022 Jun 17.
Hemorrhoids, a common anorectal disease, seriously affects patients' quality of life. Micronized purified flavonoid fractions (MPFF) have been shown to improve hemorrhoid symptoms.
To evaluate the efficacy and safety of MPFF in treating postoperative hemorrhoid complications.
A systematic review and meta-analysis of existing literature on natural compounds for treating postoperative complications of hemorrhoids.
A literature search was conducted using five databases, namely PubMed, WanFang, CNKI, Embase, and the Cochrane Library, to identify randomized controlled trials (RCTs) on the effects of MPFF treatment on hemorrhoids. Stata 15.1 and Revman 15.4 were used to assess the data, while subgroup and sensitivity analyses were performed to evaluate potential heterogeneity, and trial sequential analysis (TSA) and Egger test were used to evaluate the reliability of each trial.
A total of 22 RCTs, including 2,335 participants were included in the analysis. MPFF improved the clinical efficacy of post-hemorrhoidectomy and reduced the bleeding rate, pain score, and edema score, although no substantial effect on adverse reactions was reported. Subgroup analyses showed a significant reduction in pain score and bleeding rate in trials with duration of 4-10 days and an improvement in clinical efficacy. Treatment for ≥ 10 days significantly improved the edema score; a dosage range of 1,800-2,700 mg/day of MPFF significantly reduced edema and pain scores, whereas < 1,800 mg/day significantly improved clinical efficacy.
Based on searching the relevant literatures, this is the first meta-analysis on MPFF treatment of postoperative hemorrhoid complications. Our findings, validated by TSA, suggest that MPFF is safe and effective in reducing postoperative hemorrhoid complications, and that dose and duration are key factors in its efficacy, as illustrated by subgroup analysis. However, due to the small sample size, the standardized treatment regimen of MPFF could not be obtained; therefore, further research is warranted.
痔疮是一种常见的肛肠疾病，严重影响患者的生活质量。已证实微粒化纯化黄酮类混合物（MPFF）可改善痔疮症状。
评估 MPFF 治疗痔疮术后并发症的疗效和安全性。
对治疗痔疮术后并发症的天然化合物的现有文献进行系统评价和荟萃分析。
使用 5 个数据库（PubMed、万方、CNKI、Embase 和 Cochrane Library）对关于 MPFF 治疗痔疮效果的随机对照试验（RCT）进行文献检索。使用 Stata 15.1 和 Revman 15.4 评估数据，进行亚组和敏感性分析以评估潜在的异质性，并进行试验序贯分析（TSA）和 Egger 检验以评估每个试验的可靠性。
共纳入 22 项 RCT，共 2335 名参与者。MPFF 提高了痔切除术后的临床疗效，降低了出血率、疼痛评分和水肿评分，但未报告不良反应发生率有显著降低。亚组分析显示，在持续时间为 4-10 天的试验中，疼痛评分和出血率显著降低，在持续时间为≥10 天的试验中，水肿评分显著改善；MPFF 的剂量范围为 1800-2700mg/天，可显著降低水肿和疼痛评分，而剂量＜1800mg/天则可显著改善临床疗效。
基于对相关文献的检索，这是首次对 MPFF 治疗痔术后并发症的荟萃分析。经 TSA 验证，我们的发现表明，MPFF 安全且有效，可降低痔疮术后并发症的发生率，并且剂量和时间是其疗效的关键因素，亚组分析对此进行了说明。但是，由于样本量较小，未能获得 MPFF 的标准化治疗方案；因此，需要进一步的研究。
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