摘要
目的利用Meta分析评价在经皮椎体强化术基础上联合使用桃红四物汤治疗骨质疏松性胸腰椎压缩性骨折的有效性和安全性。方法计算机检索中国知网、万方、维普和PubMed、Cochrane Library数据库,检索建库至2021年10月公开发表的文献,纳入经皮椎体强化术联合应用桃红四物汤治疗方案对比单纯使用椎体强化术的随机对照试验,由2名研究者按Cochrane手册标准独立评价文献质量、提取数据并交叉核对,使用RevMan5.4软件进行Meta分析。结果纳入文献12篇,样本量共计1145例。Meta分析结果显示,试验组的有效率[OR=4.22,95%CI(2.77,6.43),P<0.0001]、骨密度[MD=0.20,95%CI(0.09,0.30),P<0.00001]、骨代谢指标(BGP[MD=1.34,95%CI(0.75,1.93),P<0.00001]、BALP[MD=4.69,95%CI(4.36,5.02),P<0.00001]、TP1NP[MD=11.49,95%CI(3.85,19.13),P=0.003]高于对照组,试验组VAS评分[MD=-1.10,95%CI(-1.52,-0.69),P<0.00001]、ODI评分[MD=-6.49,95%CI(-9.93,-3.04),P<0.00001]、Cobb角[MD=-3.64,95%CI(-5.67,-1.61),P<0.00001]指标、术后并发症[OR=4.22,95%CI(2.77,6.43),P<0.00001]低于对照组,比较差异有统计学意义。治疗有效率的漏斗图表明,研究散布于中线两边,分布较均匀,发表偏倚较低。结论与单纯椎体强化术相比,桃红四物汤为主方辅助椎体强化术治疗骨质疏松性胸腰椎骨折在提高有效率、骨密度、骨代谢指标方面优势明显,可降低VAS评分、ODI评分以及Cobb角,减少术后并发症的发生,从而提升整体的疗效。但仍需要更多高质量随机对照试验进一步验证。
Objective Meta-analysis was used to evaluate the efficacy and safety of the use of Taohong Siwu decoction in combination with rosacea on the basis of percutaneous vertebral augmentation in the treatment of osteoporotic thoracolumbar compression fractures.Methods The computer retrieved the databases of CNKI,Wanfang,Weipu and PubMed and Cochrane Library,retrieved the literature published from the establishment of the library until October 2021,and included the treatment plan of percutaneous vertebral augmentation combined with Taohong Siwu decoction compared with the randomized controlled trial using vertebral enhancement alone,and two researchers independently evaluated the literature quality according to the Cochrane manual standards,extracted the data and cross-checked,and used RevMan5.4 software for meta-analysis.Results There were 12 articles included,with a total sample size of 1145 cases.Meta-analysis results showed that the effective rate of the experimental group[OR=4.22,95%CI(2.77,6.43),P<0.00001],bone density[MD=0.20,95%CI(0.09,0.30),P<0.00001],bone metabolism index(BGP[MD=1.34,95%CI(0.75,1.93),P<0.00001],BALP[MD=4.69,95%CI(4.36,5.02),P<0.00001],TP1NP[MD=11.49,95%CI(3.85,19.13),P=0.003]was higher than the control group.VAS score in the experimental group[MD=-1.10,95%CI(-1.52,0.69),P<0.00001],ODI score[MD=-6.49,95%CI(-9.93,-3.04),P<0.00001],Cobb angle[MD=-3.64,95%CI(-5.67,-1.61),P<0.00001]Indicators,postoperative complications[OR=4.22,95%CI(2.77,6.43),P<0.00001]Lower than the control group,the comparison difference is statistically significant.Funnel plots of therapeutic efficiency show that studies are spread across both sides of the midline,with a more uniform distribution and lower publication bias.Conclusion Compared with pure vertebral enhancement,Taohong Siwu decoction is the main auxiliary vertebral enhancement in the treatment of osteoporotic thoracolumbar fractures in terms of improving efficiency,bone density and bone metabolism indexes,which can reduce VAS score,ODI score and Cobb angle,reduce the occurrence of postoperative complications,and thus improve the overall efficacy.However,more high-quality randomized controlled trials are needed for further validation.
作者
彭涛
魏庆中
李利超
陈兴康
刘伟涛
宁慧君
何攀
易红赤
PENG Tao;WEI Qingzhong;LI Lichao;CHEN Xingkang;LIU Weitao;NING Huijun;HE Pan;YI Hongchi(The First Affiliated Hospital of Yunnan University ofChinese Medicine,Kunming 650021,China;Yunnan University of Chinese Medicine,Kunming 650500,China)
出处
《云南中医学院学报》
2021年第6期45-53,共9页
Journal of Yunnan University of Traditional Chinese Medicine
基金
云南省高层次中医药后备人才培养项目(云卫中医发展发[2021]1号)。
关键词
桃红四物汤
骨质疏松性胸腰椎压缩骨折
椎体强化术
随机对照试验
META分析
Taohong Siwu decoction
osteoporotic thoracolumbar compression fractures
vertebral augmentation
randomized controlled trial
meta-analysis
