中医正骨2025，Vol.37Issue(5)：42-57,16.
术后应用不同中药复方口服对手术治疗足踝骨折疗效影响的网状Meta分析
Effects of oral application of different Chinese herbal compounds following the surgery on the efficacy of surgi-cal treatment of foot and ankle fractures:a network meta-analysis
摘要
Abstract
Objective:To systematically review the effects of oral application of different Chinese herbal compounds(CHCs)following the surgery on the efficacy of surgical treatment of foot and ankle fractures.Methods:All the comparative study articles about oral applica-tion of CHCs following the surgery for foot and ankle fractures included from January 1,2011 to September 29,2024 were retrieved from the China National Knowledge Infrastructure,Wanfang Database and Chinese Biomedical Literature Service System through computer.The pa-tients in experiment group were treated with oral application of CHCs combined with conventional western medicine(WM)treatment after the surgery,while the ones in control group with conventional WM treatment alone.The eligible articles were screened according to the retrieval and screening scheme.The information was extracted and the methodological quality of the included researches in the articles was evaluated independently by two researchers.After that,the reticulated plots were drawn by using Stata14.2 software,and a reticulated Meta-analysis of foot and ankle pain visual analogue scale(VAS)score,American Orthopaedic Foot and Ankle Society(AOFAS)ankle-hind score,serum tumor necrosis factor-α(TNF-α)level,serum interleukin(IL)-6 level,total clinical effective rate,and complication incidence was conduc-ted,furthermore,the adopted treatment methods were ranked according to the surface under the cumulative ranking curve(SUCRA),and the publication bias was tested by using a comparison-correction funnel plot.Results:Five thousand and six articles were searched out.After screening,75 articles were included in the final analysis.The reticulated Meta-analysis revealed that,oral application of Niuxi Huoxue Tang(牛膝活血汤,NX HXT)combined with conventional WM treatment(SUCRA=95.9％)exhibited greater superiority in improving the foot and ankle pain VAS score,followed by oral application of Shujin Huoxue Tang(舒筋活血汤,SJHXT)combined with conventional WM treatment(SUCRA=70.0％),oral application of Qiangjin Huoxue Fuyuan Tang(强筋活血复元汤,QJHXFYT)combined with convention-al WM treatment(SUCRA=62.6％),oral application of Taohong Siwu Tang(桃红四物汤,THSWT)combined with conventional WM treat-ment(SUCRA=50.5％),oral application of THSWT and Wuling San(五苓散,WLS)combined with conventional WM treatment(SUCRA=40.5％),oral application of Huoxue Jiegu Tang(活血接骨汤,HXJGT)combined with conventional WM treatment(SUCRA=28.2％),and conventional WM treatment alone(SUCRA=2.3％);the oral application of Fuyuan Huoxue Tang(复元活血汤,FYHXT)combined with conventional WM treatment(SUCRA=98.3％)behaved best in improving the AOFAS ankle-hind score,followed by oral ap-plication of SJHXT combined with conventional WM treatment(SUCRA=70.4％),oral application of THSWT combined with conventional WM treatment(SUCRA=44.0％),oral application of Qili San(七厘散,QLS)combined with conventional WM treatment(SUCRA=34.2％),and conventional WM treatment alone(SUCRA=3.2％);the oral application of Huoxue Huayu Tang(活血化瘀汤,HXHYT)combined with conventional WM treatment(SUCRA=96.5％)acted best in improving serum level of TNF-α,followed by oral application of SJHXT combined with conventional WM treatment(SUCRA=60.8％),oral application of QLS combined with conventional WM treatment(SUCRA=45.1％),oral application of NXHXT combined with conventional WM treatment(SUCRA=42.0％),and conventional WM treatment alone(SUCRA=5.6％);the oral application of HXHYT combined with conventional WM treatment(SUCRA=93.5％)acted best in improving serum level of IL-6,followed by oral application of QLS combined with conventional WM treatment(SUCRA=74.8％),oral application of SJHXT combined with conventional WM treatment(SUCRA=44.5％),oral application of Huoxue Zhentong Tang(活血镇痛汤,HXZTT)combined with conventional WM treatment(SUCRA=44.4％),and oral application of Xugu Huoxue Tang(续骨活血汤,XGHXT)combined with conventional WM treatment(SUCRA=39.7％);the oral application of Buyang Huanwu Tang(补阳还五汤,BYHWT)combined with conventional WM treatment(SUCRA=84.8％)performed best in the total clinical effective rate,followed by oral application of SJHXT combined with conventional WM treatment(SUCRA=63.9％),oral application of NXHXT combined with conven-tional WM treatment(SUCRA=56.3％),oral application of FYHXT combined with conventional WM treatment(SUCRA=51.0％),oral application of THSWT combined with conventional WM treatment(SUCRA=43.9％),and conventional WM treatment alone(SUCRA=0.0％);the oral application of XGHXT combined with conventional WM treatment(SUCRA=76.7％)excelled in reducing the incidence of complications,followed by oral application of HXHYT combined with conventional WM treatment(SUCRA=74.3％),oral application of SJHXT combined with conventional WM treatment(SUCRA=53.2％),oral application of Yipanzhu Tang(一盘珠汤)combined with con-ventional WM treatment(SUCRA=53.1％),oral application of THSWT combined with conventional WM treatment(SUCRA=42.0％),and conventional WM treatment alone(SUCRA=0.7％).Conclusion:Application of different CHCs on the basis of conventional WM ther-apies following the surgery for foot and ankle fractures can promote postoperative rehabilitation.Among the CHCs,the NXHXT exhibits grea-ter superiority in relieving the pain,the FYHXT behaves best in improving the ankle joint function,the HXHYT acts best in controlling the inflammation,the BYHWT performs best in enhancing the total clinical effective rate,and the XGHXT excels in reducing the incidence of complications.关键词
踝部骨折/踝关节/跟骨/Pilon骨折/治疗结果/复方(中药)/手术后期间/网络Meta分析Key words
ankle fractures/ankle joint/calcaneus/Pilon fractures/treatment outcome/compounds(TCD)/postoperative period/network Meta-analysis引用本文复制引用
卢泽声,蔡惟楚,李昌繁,陈铄鑫,施训清,高怡加..术后应用不同中药复方口服对手术治疗足踝骨折疗效影响的网状Meta分析[J].中医正骨,2025,37(5):42-57,16.基金项目
全国名老中医药专家传承工作室建设项目(国中医药人教函[2022]75号) （国中医药人教函[2022]75号）
