桡骨远端骨折术后应用中药的Meta分析

Meta-Analysis of the Application of Traditional Chinese Medicine after Distal Radius Fracture Surgery

摘要: 目的：系统评价中药汤剂治疗桡骨远端骨折术后早期治疗的有效性；方法：通过计算机检索CNKI、万方、维普、PubMed等数据库，收集了2015年1月至2025年1月期间的相关文献。随后，分别使用Cochrane和Revman5.3软件评估文献质量及数据分析。纳入的研究中，单纯西医治疗(术后常规抗感染、止痛、止血)为对照组，在此基础上联合中药汤剂口服的患者为实验组；结果：经过筛选和分析，共纳入了36篇文献，涉及2969例样本(观察组n = 1488；对照组n = 1481)。整理结果如下，VAS (2周)评分[MD = −1.11, 95% CI (−1.58, −0.64), Z = 4.64, P < 0.00001]，RUSS评分[MD = 1.07, 95% CI (0.79, 1.35), Z = 7.52, P < 0.0001]；术后4周Cooney评分[MD = 5.86, 95% CI (3.09, 8.63), Z = 4.15, P < 0.0001]，VAS评分[MD = −0.84, 95% CI (−0.99, −0.69), Z = 10.82, P < 0.0001]，Gartland-Werley评分[MD = −1.81, 95% CI (−3.00, −0.63), Z = 3.00, P = 0.003]，RUSS评分[MD = 11.06, 95% CI (0.83, 1.19), Z = 11.06, P < 0.00001]，骨折愈合时间(4周) [MD = −1.49, 95% CI (−1.76, −1.21), Z = 10.59, P < 0.00001]；骨折愈合时间(8周) [MD = −0.94, 95% CI (−1.23, −0.65), Z = 6.27, P < 0.00001]，Gartland-Werley评分[MD = −0.77, 95% CI (−1.08, −0.46), Z = 4.90, P < 0.00001]，PRWE评分[MD = −0.95, 95% CI (−1.37, −0.54), Z = 4.49, P < 0.00001]，RUSS评分[MD = 0.59, 95% CI (0.26, 0.93), Z = 3.51, P = 0.0005]。结论：在术后的2周、4周、8周，中药汤剂治疗组在疼痛缓解程度、腕关节功能活动度、功能评分以及骨折愈合时间等关键指标上，均优于对照组。这一结果支持中药在桡骨远端骨折术后患者早期治疗中的潜在治疗价值，但需更多高质量研究进一步验证其因果关联。它不仅为临床实践提供了重要的参考，也为中医药在现代骨科治疗中的应用和发展提供了有力支持。

Abstract: Objective: To evaluate the efficacy of traditional Chinese medicine decoction in the early postoperative treatment of distal radius fractures. Methods: China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP database, PubMed database and other databases were searched by computer, and relevant articles from January 2015 to January 2025 were collected. Subsequently, Cochrane Collaboration was used to evaluate the quality of the literature, and Revman5.3 software was used for data analysis. In the included studies, the control group was treated with conventional western medicine, while the observation group was treated with oral Chinese medicine decoction on the basis of the control group. Results: After screening and analysis, a total of 36 articles were included, involving 2969 samples (observation group n = 1488; Control group n = 1481). Meta-analysis showed that VAS score [MD = −1.11, 95% CI (−1.58, −0.64), Z = 4.64, P < 0.00001] and RUSS score [MD = 1.07, 95% CI (0.79, 1.35), Z = 7.52, P < 0.0001] at 2 weeks after surgery; 4 weeks after surgery, Cooney score [MD = 5.86, 95% CI (3.09, 8.63), Z = 4.15, P < 0.0001], VAS score [MD = −0.84, 95% CI (−0.99, −0.69), Z = 10.82, P < 0.0001], Gartland-Werley score [MD = −1.81, 95% CI (−3.00, −0.63), Z = 3.00, P = 0.003], RUSS score [MD = 11.06, 95% CI (0.83, 1.19), Z = 11.06, P < 0.00001], fracture healing time [MD = −1.49, 95% CI (−1.76, −1.21), Z = 10.59, P < 0.00001]. Fracture healing time at 8 weeks after operation [MD = −0.94, 95% CI (−1.23, −0.65), Z = 6.27, P < 0.00001], Gartland-Werley score [MD = −0.77, 95% CI (−1.08, −0.46), Z = 4.90, P < 0.00001], PRWE score [MD = −0.95, 95% CI (−1.37, −0.54), Z = 4.49, P < 0.00001], and RUSS score [MD = 0.59, 95% CI (0.26, 0.93), Z = 3.51, P = 0.0005]. Conclusion: At 2 weeks, 4 weeks and 8 weeks after operation, the Chinese medicine decoction treatment group is superior to the control group in the key indexes such as pain relief, wrist functional range of motion, functional score and fracture healing time. This result supports the potential therapeutic value of traditional Chinese medicine in early treatment of patients with distal radius fracture after operation, but more high-quality research is needed to further verify its causal relationship. It not only provides an important reference for clinical practice, but also provides strong support for the application and development of traditional Chinese medicine in modern orthopedic treatment.