血府逐瘀汤治疗肋骨骨折合并血胸临床疗效的Meta分析

Meta-Analysis of Clinical Efficacy of Xuefu Zhuyu Decoction in Treating Rib Fracture Complicated with Hemothorax

摘要: 目的：系统评价血府逐瘀汤治疗肋骨骨折合并血胸的疗效，为后续临床及相关研究提供一定的参考意义。方法：使用计算机查阅以下数据库：CNKI，VIP，CBM，Wanfang，PubMed，Cochrane Library，Embase。查阅内容为血府逐瘀汤对比西医常规治疗肋骨骨折合并血胸的临床随机对照试验，查阅时间为以上数据库建库起至2023年9月。由两名评估人员通过Cochrane风险偏倚评价文献质量。运用RevMan 5.3软件对提取的数据进行Meta分析。结果：纳入14项随机对照研究，Meta分析结果提示血府逐瘀汤组对比西医常规治疗效果优于常规治疗组而言：疗效更优[OR = 3.12, 95%CI (1.98, 4.92), Z = 4.92, P < 0.00001]；VAS评分结果更佳[MD = −1.60, 95%CI (−2.49, −0.70), Z = 3.50, P = 0.0005]；凝血功能：PT指标结果明显改善[MD = 1.28, 95%CI (0.38, 2.18), Z = 2.79, P = 0.005]，APTT指标结果明显改善[MD = 1.11, 95%CI (0.42, 1.79), Z = 3.16, P = 0.002]，FIB指标明显改善[MD = −0.88, 95%CI (−1.14, −0.61), Z = 6.41, P < 0.00001]，TT指标结果无统计学意义[MD = 2.48, 95%CI (−0.17, 5.13), Z = 1.84, P = 0.07]，DD指标结果明显改善[MD = −166.66, 95%CI (−292.35, −40.97), Z = 2.60, P = 0.009]；消失时间：疼痛消失时间更短[MD = −3.49, 95%CI (−5.01, −1.98), Z = 4.52, P < 0.00001]，血肿消失时间指标结果无统计学意义[MD = −0.77, 95%CI (−5.99, 4.46), Z = 0.29, P = 0.77]；住院时间缩短[MD = −3.82, 95%CI (−6.18, −1.46), Z = 3.18, P = 0.001]。结论：运用血府逐瘀汤类方治疗肋骨骨折合并血胸患者在疗效、VAS评分、凝血功能、疼痛消失时间、住院时间方面均有改善。

Abstract: Objective: To systematically evaluate the efficacy of Xuefu Zhuyu Decoction in the treatment of rib fracture combined with hemothorax, and to provide certain reference significance for subsequent clinical and related studies. Methods CNKI, VIP, CBM, Wanfang, PubMed, Cochrane Library and Em-base were searched by computer. The content of the review is the randomized controlled clinical trial of Xuefu Zhuyu Decoction compared with conventional Western medicine in the treatment of rib fracture combined with hemothorax. The review time is from the establishment of the above database to September 2023. Literature quality was assessed by Cochrane risk bias by two evalua-tors. Meta-analysis of the extracted data was performed using RevMan 5.3 software. Results: Four-teen randomized controlled studies were included. Meta-analysis results suggested that Xuefu Zhuyu decoction group had better efficacy than conventional western medicine treatment group [OR = 3.12, 95%CI (1.98, 4.92), Z = 4.92, P < 0.00001]. VAS score results better [MD = −1.60, 95%CI (−2.49, −0.70), Z = 3.50, P = 0.0005]. Coagulation function: The results of PT index were significantly improved [MD = 1.28, 95%CI (0.38, 2.18), Z = 2.79, P = 0.005], and the results of APTT index were significantly improved [MD = 1.11, 95%CI (0.42, 1.79), Z = 3.16, P = 0.002]. FIB index improved sig-nificantly [MD = −0.88, 95%CI (−1.14, −0.61), Z = 6.41, P < 0.00001], TT index results were not sta-tistically significant [MD = 2.48, 95%CI (−0.17, 5.13), Z = 1.84, P = 0.07]. DD index results obviously improve [MD = −166.66, 95%CI (−292.35, −40.97), Z = 2.60, P = 0.009]. Time of disappearance: Pain disappearance time is shorter [MD = −3.49, 95%CI (−5.01, −1.98), Z = 4.52, P < 0.00001]; There was no statistical significance in the disappearance time of hematoma [MD = −0.77, 95%CI (−5.99, 4.46), Z = 0.29, P = 0.77]. Shorten the hospitalization time [MD = −3.82, 95%CI (−6.18, −1.46), Z = 3.18, P = 0.001]. Conclusion: Xuefu Zhuyu Decoction can improve the therapeutic effect, VAS score, coagula-tion function, pain disappearance time and hospital stay in patients with rib fracture complicated with hemothorax.