Literature Study On The Clinical Efficacy And Safety Of Traditional Chinese Medicine For Thrombotic Superficial Phlebitis

Purpose:The clinical efficacy and safety of Chinese medicine for superficial thrombophlebitis were systematically evaluated by evidence-based medicine.It provides scientific basis for the clinical decision of Chinese medicine in treating superficial thrombophlebitis.Materials and Methods:Search for EMbase,Cochrane Library,Pubmed database,CNKI,VIP,Wanfang database till December 2018,and collect the combination of traditional Chinese and Western medicine for the treatment of STP.Randomized controlled trials were screened for RCT criteria for Cochrane Handbook 5.1.0,which met the inclusion criteria,and meta-analyzed using Review Manage5.3 software.Result:There are 27 articles were included in the study.The total number of samples was 2351,including 1218 in the treatment group and 1133 in the control group.Of the 27 articles included,6 reported adverse reactions,and 1 had statistical analysis of adverse reactions.According to the quality evaluation of Cochrane Handbook 5.1.0,8 of the 27 papers included in 1 used the random number table method,and one paper used the method of computer lottery.The rest of the literature mentioned random but not described.Specific random methods;2 all trials did not mention covert grouping;3 none of the 27 articles included mentioning whether blinding was used;4 of the 27 articles included in the description of the exit and the reasons,Other literature did not mention whether there were any loss of follow-up and withdrawal;5 all literatures did not have selective reporting bias;6 of the 27 papers included,26 papers described the baseline as consistent,and 1 document did not mention whether there were other biases source.Meta analysis results show: 1.Clinical efficacy index of superficial thrombophlebitis(1)the difference in clinical efficacy was statistically significant in the O group of superficial thrombophlebitis.[OR=6.04,95%CI(3.00,5.12),Z=11.45,P<0.00001].(2)the difference in clinical efficacy of superficial thrombophlebitis group A was statistically significant [OR=6.88,95%CL(4.53,10.46),Z=9.03,P<0.00001].(3)the difference in clinical efficacy of group B for superficial thrombophlebitis was statistically significant [OR=5.08,95%CL(3.22,8.02),Z=6.99,P<0.00001].2.Fibrinogen index of superficial thrombophlebitis(1)The differences of fibrinogen in the O group of superficial thrombophlebitis were statistically significant.[MD=-0.58,95%CI(-0.79,-0.37),Z=5.51,P<0.00001](2)there were statistically significant differences in fibrinogen between group A and western medicine in the treatment of superficial thrombophlebitis [MD=-0.26,95%CI(-0.46,-0.06),Z=2.55,P=0.01].3.Whole blood viscosity index of superficial thrombophlebitis(1)The differences of whole blood viscosity in the O group of superficial thrombophlebitis were statistically significant.[MD=-0.23,95%CI(-0.35,-0.12),Z=4.03,P<0.0001](2)the differences of whole blood viscosity in the group A of combined Chinese and western medicine in the treatment of superficial thrombophlebitis were statistically significant [MD=-0.26,95%CI(-0.46,-0.06),Z=2.55,P=0.01].4.The difference in symptom and sign scores(pain)of the group O treated with combination of traditional Chinese and western medicine was statistically significant [MD=-0.58,95%CI(-0.78,-0.37),Z=5.56,P<0.00001].5.The difference in symptom and sign scores(swelling)of the group O in the treatment of superficial thrombophlebitis by integrated Chinese and western medicine was statistically significant [MD=-0.56,95%CI(-0.62,-0.49),Z=17.34,P<0.00001].6.Therapeutic time index of superficial thrombophlebitis(1)The cure time of superficial thrombophlebitis group O was statistically significant.[MD=-4.97,95%CI(-6.69,-3.26),Z=5.68,P<0.00001](2)there was no statistically significant difference in the curing time of superficial thrombophlebitis treated by combination of Chinese and western medicine in group A [MD=-5.70,95%CL(-9.49,-1.91),Z=2.95,P=0.003].(3)there were statistically significant differences in the healing time of group B in the treatment of superficial thrombophlebitis by integrated Chinese and western medicine [MD=-4.16,95%CL[-4.79,-3.54],Z=12.98,P<0.00001].The analysis results of STP clinical efficacy indicators of traditional Chinese medicine treatment showed that: Superficial thrombophlebitis is commonly treated for promoting blood circulation and removing blood stasis,clearing heat and detoxifying,followed by promoting blood circulation and removing blood stasis,dehumidifying and dredging collaterals.The most common types of STP are blood-activating drugs,heat-clearing and anti-toxin,heat-clearing and blood-cooling drugs,and anti-swelling and anti-swelling drugs.Commonly used Chinese traditional medicine from high to low ranking for angelica,honeysuckle,cortex phellodendri,red peony root,purple flower ground,leech,astragalus,atractylodes,salvia miltiorrhizae,radix salviae root,coix seed,Dan PI,forsythia,licorice,peach kernel,alisma,radix ginseng,poria cocos,earth dragon,safflower,suberect spatholobus,etc.Conclusion:Meta-analysis results show that the combination of traditional Chinese and Western medicine for the treatment of STP can improve clinical efficacy,reduce fibrinogen and whole blood viscosity,improve calf circumference diameter difference,improve symptom and body score,and speed up healing time,which is worthy of clinical promotion.In terms of clinical efficacy,internal treatment of integrated traditional Chinese and western medicine is more effective than external treatment of integrated traditional Chinese and western medicine.In terms of cure time,the curative effect of external treatment of integrated Chinese and western medicine is superior to internal treatment of integrated Chinese and western medicine.Superficial thrombophlebitis is commonly treated for promoting blood circulation and removing blood stasis,clearing heat and detoxifying,followed by promoting blood circulation and removing blood stasis,dehumidifying and dredging collaterals.The most common types of STP are blood-activating drugs,heat-clearing and anti-toxin,heat-clearing and blood-cooling drugs,and anti-swelling and anti-swelling drugs.Common Chinese traditional medicine from high to low ranking for angelica,honeysuckle,cortex phellodendri,red peony root and so on.However,due to the inclusion of literature quality limitations,there may be a publication bias,and more randomized controlled trials are still needed to validate.