Meta Analysis And Literature Analysis Of Traditional Chinese Medicine In The Treatment Of Glucoticorticoid-associated Osteonecrosis Of The Femoral Head

Objective: To systematically evaluate the clinical efficacy and safety of traditional Chinese medicine(TCM)for the treatment of glucoticorticoidassociated osteonecrosis of the femoral head in order to provide evidence-based medical evidence for clinical decision-making.Based on the method of literature metrology,understand the overall situation and research hotspots of Chinese medicine treatment of steroid induced femoral head necrosis,and explore the research frontier in this fieldMethods: The databases including CNKI,Wanfang database,vip,CBM,Pub Med,EMBASE,web of science,the Cochrane library were searched,and other sources were used to obtain randomized controlled studies of traditional Chinese medicine(TCM)for the treatment of glucoticorticoid-associated osteonecrosis of the femoral head,and the search period was limited to January2023.Screening of the included literature,meta-analysis of outcome measures from the final included literature was performed using Review Manager software.Studies on traditional Chinese medicine treatment of glucoticorticoidassociated osteonecrosis of the femoral head were obtained by searching the Chinese knowledge net,and the retrieval time was limited to construct the bank until January 2023.After excluding those that did not meet the requirements,the included papers were analyzed for annual publication volume,funding situation,journal name,academic thesis publication institution,and so on,and the software Cite Space was used to visualize the journal authors,institutions,and keywords.Results: The literature of 14 RCT trials was included in the meta,metaanalysis results: of which,1179 subjects were included,590 in the intervention group and 589 in the control group.Twelve reported clinical effectiveness,meta-analysis results: RR = 1.21,95% CI(1.14,1.28),Z= 6.32,P < 0.01;There were 14 literatures reported the Harris score,meta-analysis results: intervention versus control group,MD = 12.71,95% CI(10.62,14.81),Z= 11.91,P <0.00001;Eleven reported VAS scores,meta-analysis results: MD =-1.30,95%CI(-1.44,-1.16),Z = 18.16,P < 0.00001 for intervention vs control group;Four reported on BMD,meta-analysis results: SMD = 1.02,95% CI(0.31,1.73),Z= 2.80,P = 0.005 < 0.01;Four reported high cut of whole blood viscosity,meta-analysis results: intervention vs control group,SMD =-1.37,95% CI(-1.91,-0.84),Z= 5.05,P < 0.00001;Four reported whole blood hypoviscosity cut,meta-analysis results: SMD =-2.68,95% CI(-4.18,-1.18),Z = 3.50,P =0.0005 for intervention versus control group;Four reported plasma viscosity,results of Meta-Analysis: SMD =-2.73,95% CI(-3.75,-1.71),Z = 5.25,P <0.00001 for intervention vs control group;Two reported SF-36 scores,metaanalysis results: intervention vs control,SMD = 1.46,95% CI(1.13,1.80),Z =8.57,P < 0.00001;There were 11 reports reporting the number of adverse effects,meta-analysis results: intervention versus control,RR = 0.58,95% CI(0.37,0.93),Z = 2.25,P < 0.05,all above P values less than 0.05,statistically significant difference between intervention and control groups.The relevant literature on TCM for the treatment of glucoticorticoidassociated osteonecrosis of the femoral head has been rising year by year,mainly based on journal literature,of which 63.27% of the literature was funded by the National Natural Science Foundation of China,with Zheng bone TCM being the most studied journal included,accounting for 6.8% of the total,followed by Chinese Journal of TCM,Chinese tissue engineering research.The largest number of thesis,16.33%,was from Guangzhou University of traditional Chinese medicine.The authors with the largest number of publications on TCM treatment of glucoticorticoid-associated osteonecrosis of the femoral head are Zhenxi Qi with 24 articles,of which there are 6 large cooperative networks dominated by core authors,and Linzhong Cao with the most active publications in 2016-2023.The main publication body of traditional Chinese medicine in the field of glucoticorticoid-associated osteonecrosis of the femoral head is Fujian University of Chinese medicine with 39 articles,and the scope of the collaboration involves a wide area,with connections to South China,East China,Northwest China,and.The key words mainly refer to the disease name,traditional Chinese medicine,research category,review,etc.,in which TCM contains TCM compound formulas,TCM therapies,etc.,and the research category mainly relates to experimental research,clinical experiments,etc.Conclusion(s): 1.In the treatment of steroid induced femoral necrosis in traditional Chinese medicine,it is superior in improving the patient’s effective rate,Harris score,bone density condition,SF-36 score,changing the indicators of blood rheology,and reducing the VAS score than the treatment of Western medicine alone.Secondly,traditional Chinese medicine treatment for patients with steroid induced femoral necrosis is superior to western medicine treatment alone in reducing adverse effects,with a higher safety profile and fewer side effects,which should be promoted and valued.2.The literature of traditional Chinese medicine in the treatment of glucoticorticoid-associated osteonecrosis of the femoral head is dominated by journal literature,and the annual volume of publications is constantly rising,and this research has gradually become a hot spot.Zheng bone,Journal of Chinese traditional medicine orthopedics,tissue engineering research,China)are the major journals in TCM for the treatment of steroid induced osteonecrosis of the femoral head;Guangzhou University of traditional Chinese medicine,Chengdu University of traditional Chinese medicine,and Fujian University of traditional Chinese medicine served as the provenance of the main degree papers in this field.3.Fund funding the situation of TCM for the treatment of glucoticorticoid-associated osteonecrosis of the femoral head is more optimistic,when more fund support and input is still needed.4.Chinese medicine in the treatment of glucoticorticoid-associated osteonecrosis of the femoral head there are core authors of Zhenxi Qi,Peijian Tong,Ruwei Xiao and Wei He,etc.,who make up a large collaborative network by connecting other authors.The contingency test suggested that Cao Linzhong may continue to contribute his research results in this field in the future.5.Interagency publication and cooperation the cooperation is extensive across South China,East China,Northwest China,and North China.Institutional contingency testing suggested that the Affiliated Hospital of Gansu University of traditional Chinese medicine and Gansu University of traditional Chinese medicine may provide more studies in the future.6.Hormone induced femoral head necrosis,traditional Chinese medicine compound formulas,experimental studies,traditional Chinese medicine therapies,signal pathways,and other keywords appear frequently,and experimental studies appear more than in the review,which is beneficial to the development of current Chinese medicine treatments for hormone induced femoral head necrosis.