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Efficacy and safety of micronized purified flavonoid fractions for the treatment of postoperative hemorrhoid complications: A systematic review and meta-analysis
Phytomedicine ( IF 7.9 ) Pub Date : 2022-06-17 , DOI: 10.1016/j.phymed.2022.154244
Haiqi Fu 1 , Wenfang Guo 2 , Baochang Zhou 1 , Yibo Liu 1 , Yuan Gao 3 , Minhui Li 4
Affiliation  

Background

Hemorrhoids, a common anorectal disease, seriously affects patients’ quality of life. Micronized purified flavonoid fractions (MPFF) have been shown to improve hemorrhoid symptoms.

Purpose

To evaluate the efficacy and safety of MPFF in treating postoperative hemorrhoid complications.

Study design

A systematic review and meta-analysis of existing literature on natural compounds for treating postoperative complications of hemorrhoids.

Methods

A literature search was conducted using five databases, namely PubMed, WanFang, CNKI, Embase, and the Cochrane Library, to identify randomized controlled trials (RCTs) on the effects of MPFF treatment on hemorrhoids. Stata 15.1 and Revman 15.4 were used to assess the data, while subgroup and sensitivity analyses were performed to evaluate potential heterogeneity, and trial sequential analysis (TSA) and Egger test were used to evaluate the reliability of each trial.

Results

A total of 22 RCTs, including 2,335 participants were included in the analysis. MPFF improved the clinical efficacy of post-hemorrhoidectomy and reduced the bleeding rate, pain score, and edema score, although no substantial effect on adverse reactions was reported. Subgroup analyses showed a significant reduction in pain score and bleeding rate in trials with duration of 4–10 days and an improvement in clinical efficacy. Treatment for ≥ 10 days significantly improved the edema score; a dosage range of 1,800–2,700 mg/day of MPFF significantly reduced edema and pain scores, whereas < 1,800 mg/day significantly improved clinical efficacy.

Conclusions

Based on searching the relevant literatures, this is the first meta-analysis on MPFF treatment of postoperative hemorrhoid complications. Our findings, validated by TSA, suggest that MPFF is safe and effective in reducing postoperative hemorrhoid complications, and that dose and duration are key factors in its efficacy, as illustrated by subgroup analysis. However, due to the small sample size, the standardized treatment regimen of MPFF could not be obtained; therefore, further research is warranted.



中文翻译:

微粉化纯化黄酮组分治疗痔术后并发症的疗效和安全性:系统评价和荟萃分析

背景

痔疮是一种常见的肛肠疾病,严重影响患者的生活质量。已显示微粉化纯化黄酮组分 (MPFF) 可改善痔疮症状。

目的

评价MPFF治疗痔术后并发症的疗效和安全性。

学习规划

对用于治疗痔疮术后并发症的天然化合物的现有文献进行系统评价和荟萃分析。

方法

使用 PubMed、WanFang、CNKI、Embase 和 Cochrane Library 五个数据库进行文献检索,以确定 MPFF 治疗对痔疮的影响的随机对照试验 (RCT)。使用Stata 15.1和Revman 15.4评估数据,同时进行亚组和敏感性分析以评估潜在的异质性,并使用试验序贯分析(TSA)和Egger检验来评估每个试验的可靠性。

结果

共有 22 项 RCT,包括 2,335 名参与者被纳入分析。MPFF 改善了痔切除术后的临床疗效,降低了出血率、疼痛评分和水肿评分,但未报告对不良反应有实质性影响。亚组分析显示,在为期 4-10 天的试验中,疼痛评分和出血率显着降低,临床疗效有所改善。治疗≥10天显着改善水肿评分;MPFF 1,800–2,700 mg/天的剂量范围显着降低了水肿和疼痛评分,而 < 1,800 mg/天显着提高了临床疗效。

结论

这是在查阅相关文献的基础上,首次对MPFF治疗痔术后并发症的荟萃分析。我们的研究结果经 TSA 验证,表明 MPFF 在减少术后痔并发症方面是安全有效的,并且剂量和持续时间是其疗效的关键因素,如亚组分析所示。但由于样本量小,无法获得MPFF的标准化治疗方案;因此,有必要进行进一步的研究。

更新日期:2022-06-17
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