补肾活血方联合经皮椎体强化术治疗骨质疏松性椎体压缩骨折的系统评价  

Oral application of Bushen Huoxue Fang (补肾活血方) combined with percutaneous vertebral augmentation for treatment of osteoporotic vertebral compression fractures: a systematic review

作　　者：李兆勇 杨少锋[1] 张晨阳[2] LI Zhaoyong;YANG Shaofeng;ZHANG Chenyang(The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine,Changsha 410007,Hunan,China;Hunan University of Traditional Chinese Medicine,Changsha 410208,Hunan,China)

机构地区：[1]湖南中医药大学第一附属医院,湖南长沙410007 [2]湖南中医药大学,湖南长沙410208

出　　处：《中医正骨》2019年第3期28-32,共5页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金：湖南省自然科学基金项目(2017JJ2208)

摘　　要：目的:评价补肾活血方联合经皮椎体强化术治疗骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture,OVCF)的临床疗效和安全性。方法:应用计算机检索中国知网、维普网、万方数据库2010年1月1日至2018年10月12日收录的有关补肾活血方联合经皮椎体强化术(治疗组)和单纯经皮椎体强化术(对照组)治疗OVCF的随机对照临床研究文献。由2位研究者独立筛选文献、提取资料,依据Jadad量表进行文献方法学质量评价后,采用Rev Man4. 2. 7软件进行Meta分析。结果:最初共检索到136篇文献,经筛选后最终纳入14篇文献,均为中文文献。Meta分析结果显示,与对照组相比,治疗组的治疗有效率更高[OR=4. 06,95%CI(2. 26,7. 30)]、治疗后的疼痛视觉模拟量表评分更低[WMD=-0. 97,95%CI(-1. 50,-0. 44)]; 2组治疗后的骨密度比较,差异无统计学意义[WMD=0. 05,95%CI(-0. 01,0. 11)];仅有1篇文献比较了2组的并发症,且2组均未出现并发症,故无法进行合并分析。利用治疗后疼痛视觉模拟量表评分进行发表偏倚分析,漏斗图显示分布不对称,提示可能存在潜在的发表偏倚。结论:补肾活血方联合经皮椎体强化术是治疗OVCF的有效方法,其疗效优于单纯经皮椎体强化术。Objective:To evaluate the clinical curative effects and safety of oral application of Bushen Huoxue Fang(补肾活血方,BSHXF)combined with percutaneous vertebral augmentation for treatment of osteoporotic vertebral compression fractures(OVCF).Methods:All the randomized controlled trial(RCT)articles about combination therapy of oral application of BSHXF and percutaneous vertebral augmentation(treatment group)versus monotherapy of percutaneous vertebral augmentation(control group)for treatment of OVCF included from January 1,2010 to October 12,2018 were retrieved from China national knowledge internet,VIP Database and WanFang Database through computer.The articles were screened and the information was extracted independently by two searchers.The methodological quality of research in the articles was evaluated by using Jadad scale and a Meta-analysis was conducted by using RevMan4.2.7 software.Results:One hundred and thirty-six articles were searched out in the initial stage.After screening,14 Chinese articles were included in the final analysis.The results of Meta-analysis demonstrated that the effective rates were higher and the posttreatment pain visual analogue scale(VAS)scores were lower in treatment group compared to control group( OR =4.06,95% CI (2.26,7.30);WMD =-0.97,95% CI (-1.50,-0.44)).There was no statistical difference in posttreatment bone mineral density between the 2 groups( WMD =0.05,95% CI (-0.01,0.110)).The complication rates were compared between the 2 groups in 1 article and no complications were found in the 2 groups,so merged analysis could not be conducted.Publication bias was analyzed according to posttreatment pain VAS scores,and the asymmetrical funnel plot demonstrated that there was potential publication bias.Conclusion:The combination therapy of oral application of BSHXF and percutaneous vertebral augmentation is an effective method for treatment of OVCF,and it surpasses the monotherapy of percutaneous vertebral augmentation in the clinical curative effect.

关 键 词：骨质疏松性骨折 脊柱骨折 补肾活血方 椎体成形术 椎体后凸成形术 Meta分析 系统评价 

分 类 号：R687.3[医药卫生—骨科学] R580[医药卫生—外科学]