中医治疗全髋关节置换术后隐性失血的疗效与安全性——一项系统评价与Meta分析

Effects and Safety of Traditional Chinese Medicine for Hidden Blood Loss after Total Hip Arthroplasty-A Systematic Review and Meta-Analysis.

作者信息

Yang Ze, Wang Xiang, Xu Zheyun, Xu Qike, Xia Yongliang, Ji Weifeng

机构信息

The First Clinical Medical College, Zhejiang Traditional Chinese Medical University, Hangzhou 310053, China.

Department of Orthopedics, Tongde Hospital of Zhejiang Province, Hangzhou 310012, China.

出版信息

Evid Based Complement Alternat Med. 2022 Aug 5;2022:6937295. doi: 10.1155/2022/6937295. eCollection 2022.

DOI:10.1155/2022/6937295

PMID:35966734

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9374547/

Abstract

BACKGROUND

Hidden blood loss (HBL) after total hip arthroplasty (THA) would lead to many undesirable consequences. Traditional Chinese medicine (TCM) is now increasingly used for hidden blood loss. We performed this systematic review and meta-analysis to summarize the effect and safety of TCM treatment of HBL after THA.

METHODS

We searched PubMed, Embase, Cochrane Library, CNKI, VIP, WanFang, and CBM for the updated articles published from the inception of each database to May, 2022, among which results such as abstracts, comments, letters, reviews, and case reports were excluded. The efficacy and safety of TCM treatment of HBL after THA were synthesized and discussed by the outcomes of total blood loss (TBL), hidden blood loss (HBL), hemoglobin (Hb), and hematocrit (HCT), and the incidence of adverse reactions.

RESULTS

A total of 12 articles and 881 patients were included. There were 441 cases in the intervention group and 440 cases in the control group. Compared with the control group, the intervention group had more advantages in TBL (MD = -251.68, 95% CI = [-378.36, -125]; = 3.89, < 0.00001), HBL (MD = -159.64, 95% CI = [-252.56, -66.71]; = 3.37, =0.0008), Hb (MD = 11.39, 95% CI = [7.35, 15.43]; = 5.53, < 0.00001), and HCT (MD = 2.87, 95% CI = [0.97, 4.78]; = 2.95, =0.003), and had less incidence of adverse reactions (OR = -0.20, 95% CI = [-0.35, -0.05]; = 2.64, =0.008).

CONCLUSION

TCM has advantages in the efficacy and safety of treating hidden blood loss after THA. The strength of the evidence of the research results is limited by the quality of the included literature, and more high-quality RCTs are needed to confirm.

摘要

背景

全髋关节置换术（THA）后隐性失血（HBL）会导致许多不良后果。目前，中医药（TCM）越来越多地用于治疗隐性失血。我们进行了这项系统评价和荟萃分析，以总结中医药治疗THA后HBL的效果和安全性。

方法

我们检索了PubMed、Embase、Cochrane图书馆、中国知网（CNKI）、维普资讯（VIP）、万方数据库和中国生物医学文献数据库（CBM），查找从各数据库建库至2022年5月发表的更新文章，其中排除摘要、评论、信函、综述和病例报告等结果。通过总失血量（TBL）、隐性失血量（HBL）、血红蛋白（Hb）、血细胞比容（HCT）等结果以及不良反应发生率，综合讨论中医药治疗THA后HBL的疗效和安全性。

结果

共纳入12篇文章和881例患者。干预组441例，对照组440例。与对照组相比，干预组在TBL（MD = -251.68，95%CI = [-378.36，-125]；Z = 3.89，P < 0.00001）、HBL（MD = -159.64，95%CI = [-252.56，-66.71]；Z = 3.37，P = 0.0008）、Hb（MD = 11.39，95%CI = [7.35，15.43]；Z = 5.53，P < 0.00001）和HCT（MD = 2.87，95%CI = [0.97，4.78]；Z = 2.95，P = 0.003）方面更具优势，且不良反应发生率更低（OR = -0.20，95%CI = [-0.35，-0.05]；Z = 2.64，P = 0.008）。