Sun Wen-Xi, Gao Zi-Bo, Chen Kai, Tan Ao-Wei, Chen Bo-Lai, Lu Li-Ming, Lin Yong-Peng
State Key Laboratory of Traditional Chinese Medicine Syndrome, The Second Clinical Medical College of Guangzhou University of Chinese Medicine, 510405, China.
State Key Laboratory of Traditional Chinese Medicine Syndrome, Guangzhou University of Chinese Medicine, 510405, China.
Heliyon. 2024 Aug 30;10(18):e37058. doi: 10.1016/j.heliyon.2024.e37058. eCollection 2024 Sep 30.
Spinal cord injury (SCI) is a catastrophic condition associated with spinal nerve damage, which can lead to complete or partial loss of sensory and motor functions. Chinese herbal compound prescriptions (CHCP) have shown varying degrees of therapeutic effects on spinal cord injuries. However, there is a significant lack of clinical evidence-based research to substantiate these effects.
This study aims to thoroughly assess the viability of CHCPs in postoperative SCI through network meta-analysis.
Computer searches were conducted across multiple databases, including PubMed, Cochrane Library, Embase, Web of Science, CNKI, Wanfang, VIP, and CBM, from their inception until May 2024. The meta-analysis adhered to the PRISMA guidelines and was registered in the PROSPERO database (CRD42023462686). A network meta-analysis was performed using the BUGSnet software package via R. : A network meta-analysis of randomized clinical trials (RCTs).
A total of 26 RCTs involving 1848 patients were ultimately included. The network meta-analysis revealed the effectiveness in improving ASIA motor score as follows: "HQGZD" > "Other Decoctions" > "BYHWD" > "TDHXD" > "THCQD" > "Surgery". For ASIA sensory score, the effectiveness ranking was: "HQGZD" > "Other Decoctions" > "BYHWD" > "TDHXD" > "THCQD" > "Surgery". Additionally, the experimental group had a higher ADL score compared to the control group, with a statistically difference [SMD = 1.08, 95 % CI = (0.88, 1.27), < 0.05]. The experimental group had fewer adverse events compared to the control group, with a statistically difference [RR = 0.41, 95 % CI (0.22, 0.78), < 0.05].
The findings suggest that CHCP can mprove postoperative ASIA motor and sensory scores, enhance ADL scores, and reduce adverse events following SCI surgery. Specifically, combining surgery with Huangqi Guizhi Wuwu Decoction or Buyang Huanwu Decoction may provide superior therapeutic effects in SCI treatment. Integrating CHCP into postoperative care for SCI patients may offer potential benefits.
脊髓损伤（SCI）是一种与脊神经损伤相关的灾难性疾病，可导致感觉和运动功能的完全或部分丧失。中药复方制剂（CHCP）对脊髓损伤已显示出不同程度的治疗效果。然而，严重缺乏基于临床证据的研究来证实这些效果。
本研究旨在通过网络荟萃分析全面评估中药复方制剂在脊髓损伤术后的可行性。
对多个数据库进行计算机检索，包括PubMed、Cochrane图书馆、Embase、Web of Science、中国知网、万方、维普和中国生物医学文献数据库，检索时间从各数据库建库至2024年5月。荟萃分析遵循PRISMA指南，并在PROSPERO数据库（CRD42023462686）中注册。使用BUGSnet软件包通过R进行网络荟萃分析：对随机临床试验（RCT）的网络荟萃分析。
最终纳入26项涉及1848例患者的随机对照试验。网络荟萃分析显示改善美国脊髓损伤协会（ASIA）运动评分的有效性如下：“黄芪桂枝五物汤”>“其他方剂”>“补阳还五汤”>“通督活血汤”>“桃红四物汤”>“手术”。对于ASIA感觉评分，有效性排名为：“黄芪桂枝五物汤”>“其他方剂”>“补阳还五汤”>“通督活血汤”>“桃红四物汤”>“手术”。此外，与对照组相比，试验组的日常生活活动能力（ADL）评分更高，差异有统计学意义[标准化均数差（SMD）=1.08，95%置信区间（CI）=（0.88，1.27），P<0.05]。与对照组相比，试验组的不良事件更少，差异有统计学意义[相对危险度（RR）=0.41，95%CI（0.22，0.78），P<0.05]。
研究结果表明，中药复方制剂可改善脊髓损伤术后的ASIA运动和感觉评分，提高ADL评分，并减少脊髓损伤手术后的不良事件。具体而言，手术联合黄芪桂枝五物汤或补阳还五汤在脊髓损伤治疗中可能提供更好的治疗效果。将中药复方制剂纳入脊髓损伤患者的术后护理可能具有潜在益处。
