Meta Analysis Of The Clinical Efficacy Of Traditional Chinese Medicine In The Treatment Of Avascular Necrosis Of The Femoral Head In Adults

Purpose:To explore the clinical effect of traditional Chinese medicine or traditional Chinese medicine combined with traditional western medicine in the treatment of adult femoral head ischemic necrosis.method:Extraction and retrieval keywords,formulate scientific and effective retrieval strategy,use computer to retrieve Chinese hownet(CNKI),Chinese biomedical literature database(CBM),a database of ten thousand(WF),weipu database(VIP),Pubmed database,the cochrane library,embase database from the database to literature in October 2017.The data were extracted.Clinical efficiency was taken as the main outcome indicator,and secondary outcome indicators included Harris score,VAS score and adverse reactions.Rev Man5.3 software was used for data analysis.The quality of the literature was evaluated using the quality evaluation tool provided by Cochrane collaboration.The binary classification data were expressed in RR,the continuous data were represented by MD as the consolidated statistics,and their 95% confidence interval(CI).Subgroup analysis was divided into internal therapy group,external therapy group and comprehensive therapy group according to different therapeutic methods.Results:1.A total of 54 randomized controlled trials were included,including 4525 subjects,of which 2282 were in the experimental group and 2243 in the control group.2.Compared to conventional western medicine or Chinese medicine combined with western medicine routine therapy of traditional Chinese medicine therapy for adult ONFH clinical total effective rate of treatment group is higher than the control group [Z = 9.73,RR = 1.18,95% CI(1.14,1.22),P < 0.00001],funnel basic symmetric figure.3.Compared to conventional western medicine or Chinese medicine combined with western medicine routine therapy of traditional Chinese medicine therapy for adult ONFH,a month after treatment,two groups of patients before and after treatment Harris statistically significant grade differences [Z = 2.12,MD = 7.84,95% CI(0.58,15.11),P = 0.03),treatment for over three months,the two groups before and after treatment in patients with Harris statistically significant grade differences [Z = 12.65,MD = 8.83,95% CI(7.46,10.20),P < 0.00001],when the end of six months,Harris scores before and after treatment in both groups statistically significant differences between [Z = 8.75,MD = 11.32,95% CI(8.79,13.86),P < 0.00001],when the end of twelve months,two groups of patients before and after treatment Harris statistically significant grade differences [Z = 7.59,MD = 15.11,95% CI(11.21,19.00),P < 0.00001).4.Compared to conventional western medicine or Chinese medicine combined with western medicine routine therapy of traditional Chinese medicine therapy for adult ONFH,the difference of VAS scores before and after treatment in both groups have statistical significance [Z = 5.96,MD = 1.59,95% CI(1.07,2.11),P < 0.00001).5.Subgroup analysis,three groups of efficient differences were statistically significant in the group,the external therapy group: [Z = 3.13,RR = 1.34,95% CI(1.12,1.62),P = 0.002),the internal therapy group: [Z = 8.34,RR = 1.16,95% CI(1.12,1.20),P < 0.00001],comprehensive therapy group: [Z = 5.30,RR = 1.22,95% CI(1.13,1.31),P < 0.00001),three effective of test group were higher than their respective controls.Comparison between groups,RR(external therapy)> RR(comprehensive therapy)> RR(internal therapy).Conclusion:1.Traditional Chinese medicine or Chinese medicine combined with western medicine routine therapy for adult clinical curative effect of the avascular necrosis of the femoral head is better than pure western medicine routine treatment.2.Traditional Chinese medicine or Chinese medicine combined with western medicine routine therapy for adult femoral head avascular necrosis,and at the end of the treatment of the first month,3 months,6 months and 12 months,the hip function in patients with improvement is better than pure western medicine routine treatment.3.The analgesic effect of traditional Chinese medicine or traditional Chinese medicine combined with western medicine in treating adult femoral head ischemic necrosis is better than that of western medicine alone.4.Internal medicine or internal medicine combined with western medicine routine therapy for adult clinical curative effect of the avascular necrosis of the femoral head is better than pure western medicine routine treatment;external therapy or external therapy combined with western medicine routine therapy for adult clinical curative effect of the avascular necrosis of the femoral head is better than pure western medicine routine treatment;comprehensive therapy or comprehensive therapy combined with western medicine routine therapy for adult clinical curative effect of the avascular necrosis of the femoral head is better than pure western medicine routine treatment.The treatment of adult femoral head ischemic necrosis may be superior to that of other groups.