Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Journal of Orthopaedic Surgery and Research
Published in: Journal of Orthopaedic Surgery and Research 1/2018

Open Access 01-12-2018 | Research article

Traditional Chinese and western medicine for the prevention of deep venous thrombosis after lower extremity orthopedic surgery: a meta-analysis of randomized controlled trials

Authors: Shibai Zhu, Yi Song, Xi Chen, Wenwei Qian

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2018

Login to get access

Abstract

Background

Chinese herbal medicine has traditionally been considered to promote blood circulation to remove obstruction in the channels and clear pathogenic heat to drain dampness effects. We conducted this meta-analysis to evaluate its benefits for the prevention of deep venous thrombosis (DVT) after lower extremity orthopedic surgery.

Methods

Relevant, published studies were identified using the following keywords: lower extremity orthopedic surgery, arthroplasty, joint replacement, fracture, traditional Chinese and western medicine, Chinese herbal medicine, deep venous thrombosis (DVT), and Venous thromboembolism (VTE). The following databases were used to identify the literature consisting of RCTs with a date of search of 31 May 2017: PubMed, Cochrane Library, Web of knowledge, the Chinese National Knowledge Infrastructure Database, the Chongqing VIP Database, the Chinese Biomedical Database, and the Wanfang Database (including three English and four Chinese databases). All relevant data were collected from studies meeting the inclusion criteria. The outcome variables were the incidence rate of DVT, activated partial thromboplastin time (APTT), prothrombin time (PT), and d-dimer; subcutaneous hematoma; and other reported outcomes. RevMan5.2. software was adopted for the meta-analysis.

Results

A total of 20 published studies (1862 cases) met the inclusion criteria. The experimental group, 910 patients (48.87%), received the Chinese herbal medicine or traditional Chinese and western medicine for prevention of DVT; the control group, 952 patients (51.13%), received the standard western treatment. The meta-analysis showed that traditional Chinese and western medicine therapy reduced the incidence rates of DVT significantly when compared with controls (risk ratio [RR] = 0.40; 95% CI, 0.30 to 0.54; P < 0.00001), and the d-dimer was lower in the experimental group (P = 0.01). Besides, the incidence rate of subcutaneous hematoma was lower in the experimental group (P < 0.0001). However, no significant difference was found in the PT (P = 0.98) and APTT (P = 0.75) in two groups. No serious adverse events were reported.

Conclusion

Traditional Chinese and western medicine therapy may be a safe, effective prevention modality for DVT after lower extremity orthopedic surgery. Further rigorously designed, randomized trials are warranted.
Literature
1.
Geerts WH, Bergqvist D, Pineo GF et al. Prevention of venous thromboembolism: American College of Chest Physicians evidence-based clinical practice guidelines (8th edition)[J]. Chest, 2008, 133 (6 Suppl): 381S–453S.
2.
Jacobs JJ, Mont MA, Bozic KJ, et al. American Academy of Orthopaedic Surgeons clinical practice guideline on: preventing venous thromboembolic disease in patients undergoing elective hip and knee arthroplasty. J Bone Joint Surg Am. 2012;94(8):746–7.CrossRefPubMedPubMedCentral
3.
Qiu GX. Chinese major orthopedic surgery of venous thromboembolism prevention guidelines. Chinese J Orthopaedics. 2016;36(2):70–2.
4.
Schluter J, Scotter H, Chaboyer W. Best practice guidelines for Australia and New Zealand on the prevention of venous thromboembolism: issues and implications for nurses. Contemp Nurse. 2008;29(1):3–7.CrossRefPubMed
5.
6.
Falck-Ytter Y, Francis CW, Johanson NA, et al. Prevention of VTE in orthopedic surgery patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2012;141(2 Suppl):e278S–325S.CrossRefPubMedPubMedCentral
7.
Zhang J. A retrospective study of promoting blood and removing stasis preventing venous thrombosis after artificial hip joint replacement[D]. Hunan University of Chinese Medicine, 2014.
8.
Wells GA, Shea BJ, O'Connell D, et al. The Newcastle–Ottawa scale (NOS) for assessing the quality of non-randomized studies in meta-analysis. Appl Eng Agric. 2014;18(6):727–34.
9.
Higgins JP, Green S. Cochrane handbook for systematic reviews of interventions. Naunyn-Schmiedeberg’s Arch Exp Pathol Pharmakol. 2011;5(2):S38.
10.
Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(4):264–70.CrossRefPubMed
11.
Sterne JA, Sutton AJ, Ioannidis JP, et al. Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials. BMJ (Clinical research ed). 2011;343(5):d4002.CrossRef
12.
Bi CQ, Wen JM, Jiang KW, et al. Chinese drugs for supplementing Qi and activating blood circulation in preventing deep venous thrombosis after big operations in orthopaedics and traumatology. China J Chinese Materia. 2009;34(5):625–7.
13.
Chen CL, Zhou SP, Hou YZ. Prevention of deep venous thrombosis of lower extremities with traditional Chinese and western medicine after total knee arthroplasty combined. China Prac Med. 2014;9(11):190–1.
14.
Chen T. Preventive effect of combined traditional Chinese medicine and western medicine on deep venous thrombosis of lower extremities after orthopedics. Chinese Baby. 2016;23:65–6.
15.
Ge XL, Xu GH, Shan JB. Combination of TCM and WM prevent thrombopoiesis of deep vein after artificial joint substitution. Chin Arch Tradit Chin Med. 2017;25(11):2429–30.
16.
He Y, OuYang GL, Xiao LP. Effect of Yiqi Huoxue Huayu decoction on prevention of deep venous thrombosis after artificial hip replacement. ShanXi J Tradit Chin Med. 2013;34(11):1498–9.
17.
Huang SX. Prevention of 60 cases of deep vein thrombosis after orthopedic surgery with salvia miltiorrhiza injection combined with low molecular weight heparin. Guangxi Med J. 2009;31(12):1787–8.
18.
Huang SX. Prevention of deep venous thrombosis after artificial joint replacement in lower limbs by traditional Chinese and western medicines. CJGMCM. 2010;25(7):1264–6.
19.
Jiang KW, Wen JM, Chen T, et al. Clinical observation of preventing deep vein thrombosis post major orthopedic surgery with Chinese herb. Modern J Integrated Traditional Chinese Western Med. 2011;20(12):1431–3.
20.
Li DF, Yuan ZX. Clinical observation on prevention of deep venous thrombosis after orthopedic surgery by traditional Chinese and western medicine. Med Inf. 2015;28(49):312.
21.
Li JH, Huang ZM, Li MC. Prevention of deep venous thrombosis following hip fracture surgery with rehabilitation therapy and Dang gui Sha yao herbal powder. Chin J Surg Integrated Traditional Western Med. 2015;21(6):567–70.
22.
Lin X, Wang RM, Guo YB, et al. Prevention of deep venous thrombosis after total hip arthroplasty with buyanghuanwu soup. J Shanxi College Traditional Chin Med. 2010;11(2):26–7.
23.
Shao ZH, Zhang YF, Xu YG, et al. Effect of BushenYiqiHuoxue method on prevention of deep venous thrombosis after elderly hip arthroplasty. Modern J Integrated Traditional Chinese and Western Med. 2016;25(7):765–7.
24.
Si M, Yang YM, Xu HY, et al. Effect of YiqiHuoxue method on hemorheology after artificial hip replacement. Modern J Integrated Traditional Chin Western Med. 2011;20(13):1593–4.
25.
Wang XG. Clinical observation on prevention of deep venous thrombosis after orthopedic surgery by TongmaiQiqi. Shanxi J Tradit Chin Med. 2007;38(1):72–3.
26.
Xiao G. Effect of combination of traditional Chinese and western medicine on prethrombotic state after surgery in lower limb fractures, strait. Pharmaceutical J. 2015;27(7):131–2.
27.
Yuan SH, Tong PJ. Clinical study on prevention of deep venous thrombosis after total knee replacement by integrated traditional Chinese and western medicine. Beijing J Tradit Chin Med. 2009;28(2):119–20.
28.
Zhai JB. Clinical effect of traditional Chinese and western medicine on prevention of deep venous thrombosis after elderly hip arthroplasty. Chin J Geriatric Care. 2016;14(5):16–8.
29.
Zhang FY, Chen BG, Hou N. Prevention and treatment of deep venous thrombosis of lower limbs by traditional Chinese and western medicines. Clin Med. 2009;29(8):111–2.
30.
Zhao Q, Li ZG, Li BG, et al. The effect of integrated traditional Chinese and western medicine on prevention and treatment of deep venous thrombosis after orthopedics surgery. Hebei Med J. 2014;39(7):1034–7.
31.
Zhou ZQ, Liu M, Zhao YL, et al. Effect of Honghua injection on preventing deep venous thrombosis of lower extremities after orthopedics[C]. Chinese academic communication of traditional Chinese and western medicine in peripheral vascular diseases. 2010.
32.
Simiao S. Beiji Qianjin Yao Fang [M]. Beijing: People’s Medical Publishing House; 1955.
33.
Tang ZH. Xuezheng Lun[M]. Beijing: People’s Medical Publishing House; 1990.
34.
Zhou T, Sun DQ, Wu P, et al. Clinical research on Sanmiao powder combined fibrinogenase for injection in treatment of acute deep venous thrombosis of lower limbs. CJITWM. 2012;32(7):918–21.
35.
Wei GF, Xu L, Yao H. Identification criteria and pharmacological research of Honghua. Shanxi J Traditional Chin Med. 2010;31(6):736–7.
36.
Liu YH, Yang SY, Ma WL, et al. Research progress of pharmacological action of Danggui. China Modern Med. 2014;21(22):192–4. 196
37.
Wu TT, Ding YY. The recent research review of bioactivity of Ligustrazine. Food Res Dev. 2016;37(6):212–7.
38.
Feng J, Wang SC. Effect of Fufang Danshen Diwan to platelet aggregation function. Chin J Misdiagn. 2006;6(12):2261–3.
Metadata
Title
Traditional Chinese and western medicine for the prevention of deep venous thrombosis after lower extremity orthopedic surgery: a meta-analysis of randomized controlled trials
Authors
Shibai Zhu
Yi Song
Xi Chen
Wenwei Qian
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2018
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-018-0785-2

Other articles of this Issue 1/2018

Journal of Orthopaedic Surgery and Research 1/2018 Go to the issue

Research article

F-18 FDG PET/CT in 26 patients with SAPHO syndrome: a new vision of clinical and bone scintigraphy correlation

Research article

Outcomes of oblique lateral interbody fusion for degenerative lumbar disease in patients under or over 65 years of age

Research article

Comparison of early complications between the use of a cannulated screw locking plate and multiple cancellous screws in the treatment of displaced intracapsular hip fractures in young adults: a randomized controlled clinical trial

Research article

Exposure to radial extracorporeal shock waves modulates viability and gene expression of human skeletal muscle cells: a controlled in vitro study

Research article

Roles and mechanisms of leptin in osteogenic stimulation in cervical ossification of the posterior longitudinal ligament

Systematic review

Comparative effectiveness and safety of tranexamic acid plus diluted epinephrine to control blood loss during total hip arthroplasty: a meta-analysis