中药外敷疗法对痔术后创面愈合临床疗效的Meta分析  

Clinical Efficacy of External Application of Chinese Medicine on Postoperative Wound Healing of Hemorrhoids:A Meta-Analysis

作　　者：岳鸿 杨阳[1] 吴芹萍 陈静[1] 范锡义 杨向东[2] 陈敏[3] YUE Hong;YANG Yang;WU Qin-ping(Chengdu University of Traditional Chinese Medicine,Chengdu(610075),China)

机构地区：[1]成都中医药大学,成都610075 [2]成都肛肠专科医院,成都610015 [3]成都中医药大学附属医院,成都610072

出　　处：《中国中西医结合外科杂志》2022年第3期363-369,共7页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：国家重点研发计划项目(2019YFC1709004)。

摘　　要：目的:系统评价中药外敷疗法对痔术后创面愈合的疗效,为痔术后中药外敷治疗提供依据。方法:通过中国生物医学文献数据库、PubMed、中国知网、万方、维普等数据库检索2005—2021年间国内外各医学相关期刊,根据研究目的以及参考Cochrane手册提供的质量评价标准对符合纳入标准的文献进行质量评价,使用RevMan 5.4.1软件进行Meta分析,并进行敏感性分析。结果:研究评价了12个随机对照实验,总共纳入1561例受调查者,文献整体质量一般。Meta结果显示:中药外敷有助于缩短患者创面愈合时间[SMD=-2.36,95%CI(-3.05,-1.67),P<0.001];提高愈合有效率[RR=0.20,95%CI(0.07,0.37),P=0.004];降低痔术后2 d疼痛评分[SMD=-0.33,95%CI(-0.54,-0.11),P=0.003]、降低术后6 d疼痛评分[SMD=-0.83,95%CI(-1.15,-0.50),P<0.001];降低血清中白细胞介素-6(IL-6)水平[MD=-20.69,95%CI(-32.58,-8.80),P=0.0006],以及降低痔术后血清中肿瘤坏死因子(TNF)-α水平[MD=-12.87,95%CI(-13.47,-12.28),P<0.001]等方面均优于未使用中药外敷疗法的对照组,差异有统计学意义。结论:中药外敷疗法对促进痔术后创面愈合时间、提高有效率、减轻患者痛苦等方面有一定疗效,值得临床推广。Objective To systematically evaluate the efficacy of external application of traditional Chinese medicine.Methods Searching medical-related journals in China and abroad from 2005 to 2021 through databases such as China Biology Medicine dis,PubMed,China Knowledge Network,Wanfang and Vipshop.The quality of the literature that met the inclusion criteria was evaluated according to the purpose of the study and by referring to the quality evaluation criteria provided in the Cochrane Handbook.Meta-analysis with sensitivity analysis using RevMan 5.4.1 software.Results The study evaluated 12 randomized controlled trials,which included a total of 1561 respondents,and the overall quality of the literature was ordinary.Meta results shows that topical application of external of Chinese medicine helps to shorten the healing time of patients’wounds[SMD=-2.36,95%CI(-3.05,-1.67),P<0.001];improved healing efficiency[RR=0.20,95%CI(0.07,0.37),P=0.004];reduced VAS score 2 days after hemorrhoid surgery[SMD=-0.33,95%CI(-0.54,-0.11),P=0.003];reduced VAS score 6 days after hemorrhoid surgery[SMD=-0.83,95%CI(-1.15,-0.50),P<0.001];reduced interleukin-6(IL-6)levels in serum[MD=-20.69,95%CI(-32.58,-8.80),P=0.0006]and reduced serum levels of tumor necrosis factor(TNF-α)[MD=-12.87,95%CI(-13.47,-12.28),P<0.001],which the differences were statistically significant.Conclusion The external application of Chinese medicine is effective in promoting healing time of postoperative hemorrhoid wounds,improving efficiency and reducing patients'pain,which is worthy of clinical promotion.

关 键 词：中药外敷 痔术后 创面愈合 META分析 

分 类 号：R226[医药卫生—中医基础理论]