Explore (New York, N.Y.) · 2025
Effects of traditional Chinese medicine decoctions on coagulation and deep vein thrombosis after total hip arthroplasty: Network meta-analysis.
СтатьяNetwork Meta-AnalysisОбзорНазвание и аннотация: Перевод в очереди
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Shi Hang, Zhao Yichen, Shi Xiaoyu, Hao Yimin, Ren Dongxu, Liu Yitong, Zhao Gang
Аннотация
BACKGROUND: Deep vein thrombosis (DVT) is a common and severe complication following total hip arthroplasty (THA). It significantly impacts patient recovery and quality of life. In recent years, certain traditional Chinese medicine (TCM) decoctions have shown potential in the prevention and treatment of DVT. However, a systematic evaluation of their efficacy and safety remains limited. This study aims to comprehensively assess the clinical effects and safety profile of TCM decoctions in managing DVT after THA via a network meta-analysis (NMA).
METHODS: The China Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP Database, PubMed, Embase, Cochrane Library, and Web of Science were searched to identify randomized controlled trials (RCTs) evaluating the efficacy of TCM decoctions for treating post-THA DVT from 2020 to July 17, 2024. The Cochrane risk-of-bias tool was employed to assess the methodological quality of the included studies. Data were analyzed through NMA with Stata 17 and R 4.3.2. A Bayesian random-effects model was employed for the analysis, and the surface under the cumulative ranking curve (SUCRA) values for each intervention were calculated across different outcome measures. Publication bias was assessed through funnel plots.
RESULTS: 64 studies involving 5,603 patients were included. The results demonstrated that Huoxue Tongmai Decoction (SUCRA = 74.95%, RR = 0.178, 95% credible interval (95% CrI) = 0.043, 0.521) was the most effective intervention for reducing DVT incidence rate (IR). Huoxue Xiaoshuan Decoction (SUCRA = 94.18%, weighted mean difference (WMD) = -6.42, 95% CrI: -13.7 to 0.941) was the most effective in lowering activated partial thromboplastin time (APTT), while Tongmai Decoction (SUCRA = 98.84%, WMD = -2.74, 95% CrI: -4.71 to -0.733) showed the greatest efficacy in lowering d-dimer (D-D) levels. Qingyu Decoction (SUCRA = 85.34%, WMD = -1.41, 95% CrI: -2.49 to -0.330) was the most effective intervention for fibrinogen (FIB) reduction. Huoxue Xiaoshuan Decoction (SUCRA = 80.53%, WMD = -1.93, 95% CrI: -7.32 to 3.49) was the most effective in prolonging prothrombin time (PT). Additionally, Huoxue Shujin Decoction (SUCRA = 76.38%, WMD = -2.49, 95% CrI: -14.0 to 9.07) demonstrated the highest efficacy in prolonging thrombin time (TT). In terms of DVT IR, d-D, and FIB, TCM decoctions exhibited superior efficacy in comparison to conventional treatment.
CONCLUSION: This study presents evidence that TCM decoctions can improve coagulation parameters to varying degrees and significantly reduce the incidence of DVT following THA. Among the interventions analyzed, Huoxue Tongmai Decoction exhibited the most pronounced effect in reducing DVT incidence.
METHODS: The China Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP Database, PubMed, Embase, Cochrane Library, and Web of Science were searched to identify randomized controlled trials (RCTs) evaluating the efficacy of TCM decoctions for treating post-THA DVT from 2020 to July 17, 2024. The Cochrane risk-of-bias tool was employed to assess the methodological quality of the included studies. Data were analyzed through NMA with Stata 17 and R 4.3.2. A Bayesian random-effects model was employed for the analysis, and the surface under the cumulative ranking curve (SUCRA) values for each intervention were calculated across different outcome measures. Publication bias was assessed through funnel plots.
RESULTS: 64 studies involving 5,603 patients were included. The results demonstrated that Huoxue Tongmai Decoction (SUCRA = 74.95%, RR = 0.178, 95% credible interval (95% CrI) = 0.043, 0.521) was the most effective intervention for reducing DVT incidence rate (IR). Huoxue Xiaoshuan Decoction (SUCRA = 94.18%, weighted mean difference (WMD) = -6.42, 95% CrI: -13.7 to 0.941) was the most effective in lowering activated partial thromboplastin time (APTT), while Tongmai Decoction (SUCRA = 98.84%, WMD = -2.74, 95% CrI: -4.71 to -0.733) showed the greatest efficacy in lowering d-dimer (D-D) levels. Qingyu Decoction (SUCRA = 85.34%, WMD = -1.41, 95% CrI: -2.49 to -0.330) was the most effective intervention for fibrinogen (FIB) reduction. Huoxue Xiaoshuan Decoction (SUCRA = 80.53%, WMD = -1.93, 95% CrI: -7.32 to 3.49) was the most effective in prolonging prothrombin time (PT). Additionally, Huoxue Shujin Decoction (SUCRA = 76.38%, WMD = -2.49, 95% CrI: -14.0 to 9.07) demonstrated the highest efficacy in prolonging thrombin time (TT). In terms of DVT IR, d-D, and FIB, TCM decoctions exhibited superior efficacy in comparison to conventional treatment.
CONCLUSION: This study presents evidence that TCM decoctions can improve coagulation parameters to varying degrees and significantly reduce the incidence of DVT following THA. Among the interventions analyzed, Huoxue Tongmai Decoction exhibited the most pronounced effect in reducing DVT incidence.