Meta-Analysis And Prescription Rules Analysis Of The Treatment Of Osteoporotic Vertebral Compression Fractures By The Method Of Tonifying Kidney And Nourish Essence Combined With Percutaneous Vertebroplasty

Objective: To systematically evaluate the clinical efficacy of Chinese herbal compound combined with percutaneous vertebroplasty with the main effect of Tonifying kidney and Nourish essence in the treatment of osteoporotic vertebral compression fractures by collecting related literature and using meta-analysis.The dosing pattern was analyzed through frequency analysis,association rule analysis and cluster analysis,in order to provide evidence-based medicine basis and Chinese medicine prescription for its clinical application.Methods: 1.Comprehensively search CNKI,VIP,Wan Fang,Pubmed,Embase databases by computer;Randomized controlled trial literatures on the treatment of OVCF with Chinese herbal compound combined with PVP with the main effect of Tonifying kidney and Nourish essence were searched from January 1,2013 to December 31,2022.Screening was carried out according to the inclusion and exclusion criteria,and data extraction and quality evaluation were carried out for the included literature.Finally,the relevant outcome indicators were analyzed using Revman 5.3 software.2.Searched CNKI,VIP,Wan Fang,Pubmed,Embase and databases to collect clinical research literature on the treatment of OVCF by Chinese herbal compound combined with PVP with the main effect of Tonifying kidney and Nourish essence.Relevant literature was obtained after screening according to inclusion and exclusion criteria,and the Chinese medicine prescriptions were extracted and imported into Excel 2019 software for frequency analysis of prescription drugs.Meanwhile,IBM SPSS Modeler 18.0 was used for association rule analysis and Statistics 20.0 for cluster analysis.Results: 1.A total of 22 literatures were included in the meta-analysis,with a total of 1909 patients.The results showed that: Chinese herbal compound for Tonifying kidney and Nourish essence combined with PVP is superior to single PVP in improving ODI score(MD =-5.41,95% CI [-6.36,-4.46],P <0.00001),VAS score(MD =-1.26,95% CI [-1.51,-1.00],P < 0.00001),reducing Cobb Angle(MD =-3.39,95% CI [-5.38,-1.40],P = 0.0008),reducing lumbar bone loss(MD = 0.10,95% CI [0.08,0.11],P < 0.00001),improving clinical effective rate(RR = 1.19,95% CI [1.14,1.25],P <0.00001),and preventing new vertebral fractures(RR = 1.10,95% CI [1.04,1.17],P = 0.0005),with statistical significance.2.A total of 80 articles were included in the analysis of dosing pattern,including 80 prescriptions of traditional Chinese medicine,79 traditional Chinese medicine,and the total frequency of drug use was 948 times.The top20 drugs with the frequency of use were: Rehmannia glutinosa,Angelica sinensis,Chinese yam,Epimedium,Astragalus,safflower,Psoralea,Dipsacus,Poria cocos,Rhizoma Drynariae,Achyranthus bidentata,Radix salviae miltiorrhizae,Fructus corni,Fructus wolfberry,Antler’s horn cream,Eucommia ulmoides Oliv,keel,Cuscuta chinensis,Pangolin,Chuanxiong,Pueraria lobata.The properties of the medicine are mostly warm and mild,and the taste of the medicine is mostly sweet and spicy.The meridians of the medicine are mainly liver,kidney and spleen.The association rule analysis shows that the common drug combination in the combination of two drugs is rehmannia glutinosa and cornus officinalis,and the common drug combination in the combination of three drugs is rehmannia glutinosa,angelica sinensis and yam.Three groups of commonly Chinese herbal compound prescriptions combinations were obtained in cluster analysis.Conclusions: 1.Meta analysis results showed that compared with PVP alone,Chinese herbal compound for Tonifying kidney and Nourish essence combined with PVP in the treatment of OVCF had better efficacy in improving patients’ pain and dysfunction,promoting vertebral shape recovery,reducing bone loss,improving clinical effective rate,as well as reducing the incidence of new vertebral fracture.2.The analysis of dosing pattern showed that the medicine properties of Tonifying kidney and Nourish essence method used in the treatment of OVCF were mainly warm and mild,and the medicine flavors were mainly sweet and spicy,and the medicine meridians are mainly liver,kidney and spleen.Its core drugs and medicines mainly have the functions of tonifying the kidney and strengthening the bone,nourishing the essence and filling the marrow,and are often used in combination with products that promote blood circulation and remove blood stasis,and promote qi and relieve pain.