桃红四物汤联合低分子肝素预防骨科术后深静脉血栓Meta分析  

A Meta-analysis on Taohong Siwu Decoction Combined with Low Molecular Heparin in Prevention of Deep Venous Thrombosis after Orthopedic Surgery

作　　者：吕玥[1] 阎姝[1] 刘玉波[1] 田书霞[1] LV Yue;YAN Shu;LIU Yu-bo(Department of Clinical Pharmacy,Tianjin Nankai Hospital,Tianjin(300100),China)

机构地区：[1]天津市南开医院药学部,天津300100

出　　处：《中国中西医结合外科杂志》2020年第6期1165-1171,共7页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的:系统评价桃红四物汤联合低分子肝素预防骨科术后深静脉血栓形成(DVT)的疗效及安全性。方法:全面检索Cochrane Library、EMbase、PubMed、JAMA、CNKI、维普和万方数据库中收录的桃红四物汤联合低分子肝素预防骨科术后DVT的随机对照研究(RCT),检索时限从建库—2020年6月。有两位研究者独立筛选文献、资料提取和质量评价后,采用RevMan5.4软件进行Meta分析。结果:共纳入14项RCTs,入选1150例患者。Meta分析结果显示,与低分子肝素组相比,联合组显著降低了DVT发生率[RR=0.32,95%CI(0.20,0.51),P<0.00001];联合组的视觉模拟评分法(VAS)疼痛评分[MD=-1.20,95%CI(-1.39,-1.02),P<0.00001]、术后伤口引流量[MD=-35.86,95%CI(-41.81,-29.90),P<0.00001]、血小板计数(PLT)[MD=-9.49,95%CI(-13.33,-5.66),P<0.00001]、红细胞计数(RBC)[MD=0.29,95%CI(0.23,0.36),P<0.00001]、活化部分凝血活酶时间(APTT)[MD=1.94,95%CI(1.33,2.55),P<0.00001]、血红蛋白(HGB)[MD=4.70,95%CI(3.25,6.15),P<0.00001]、D-二聚体[MD=-0.06,95%CI(-0.07,-0.06),P<0.00001]以及C反应蛋白(CRP)[MD=-1.63,95%CI(-1.94,-1.32),P<0.00001]显著优于对照组;凝血酶原时间(PT)在两组比较中无统计学意义(P>0.05)。结论:桃红四物汤联合低分子肝素预防骨科术后DVT疗效优于单用低分子肝素,且减少术后下肢深静脉血栓的形成。Objective To evaluate the efficacy and safety of combination of Taohong Siwu Decoction(THSWD)and low molecular heparin(LMH)for prevention of deep venous thrombosis(DVT)after orthopedic surgery.Methods Randomized controlled trials(RCTs)of the combination of LMH and THSWD for prevention of DVT after orthopedic surgery were searched from the Cochrane library,EMbase,PubMed,JAMA,CNKI,VIP and Wanfang database from database creation to June 2020.According to the inclusion and exclusion criteria,the data were extracted and processed by Revman 5.4.Results Fourteen RCTs involving 1150 patients were enrolled.The results showed that compared with the control group,the combined group had better effect on DVT rate[RR=0.32,95%CI(0.20,0.51),P<0.00001];VAS pain scores of the combined group[MD=-1.20,95%CI(-1.39,-1.02),P<0.00001],postoperative drainage volume[MD=-35.86,95%CI(-41.81,-29.90),P<0.00001],PLT[MD=-9.49,95%CI(-13.33,-5.66),P<0.00001],RBC[MD=0.29,95%CI(0.23,0.36),P<0.00001],APTT[MD=1.94,95%CI(1.33,2.55),P<0.00001],HGB[MD=4.70,95%CI(3.25,6.15),P<0.00001],D-dimer[MD=-0.06,95%CI(-0.07,-0.060),P<0.00001]and CRP[MD=-1.63,95%CI(-1.94,-1.32),P<0.00001]were better than those of the control group.There was no significant difference in PT between the combined group and the control group(P>0.05).Conclusion Based on the current clinical evidence,the combination of LMH and THSWD has a better effect on DVT than LMH used alone after orthopedic surgery,which could reduce deep venous thrombosis after orthopedic surgery.

关 键 词：桃红四物汤 低分子肝素 骨科手术 深静脉血栓 META分析 

分 类 号：R654.4[医药卫生—外科学]