| 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。 |
| 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 |
| DOI：10.3969/j.issn.1007-6948.2020.06.028 |
| 投稿时间：2020-07-01 |
| 基金项目: |
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| A Meta-analysis on Taohong Siwu Decoction Combined with Low Molecular Heparin in Prevention of Deep Venous Thrombosis after Orthopedic Surgery |
| LV Yue,YAN Shu,LIU Yu-bo |
| Department of Clinical Pharmacy, Tianjin Nankai Hospital, Tianjin 300100, China |
| Abstract: |
| 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 signi?cant difference in PT between the combined group and the control group (P>0.05). |
| Key words: Taohong Siwu Decoction low molecular heparin orthopedic surgery deep venous thrombosis Meta-analysis |
