中药软膏用于混合痔外剥内扎术后疗效的Meta分析OA

Objective To systematically assess the clinical efficacy of Chinese medicinal ointment after Milligan-Morgan hemorrhoidectomy(MMH)for mixed hemorrhoids.Methods Computer searches were conducted in CNKI,VIP,Wanfang Data,CBM,PubMed,and Cochrane Library to collect randomized con-trolled trials(RCTs)on the intervention of Chinese medicinal ointment for postoperative recovery after MMH for mixed hemorrhoids.The experimental group received Chinese medicinal ointment postoperatively,while the control group received routine dressing change.The retrieval period was from the establishment of each data-base to March 2025.After literature screening,data extraction and methodological quality assessment,Meta-analysis was performed using RevMan 5.3 software.Results A total of 11 RCTs were enrolled,involving 1 167 participants,among whom 602 in the experimental group treated with Chinese medicinal ointment and 565 in the control group receiving routine dressing change.Meta-analysis showed that compared with the control group,the experimental group had significantly higher total effective rate of wound healing(OR=5.94,95%CI:2.79 ‒ 12.65,P<0.00001),significantly shorter wound healing time(MD=-4.33,95%CI:-6.70--1.97,P=0.0003),and significantly lower pain scores on postoperative day 1(SMD=-0.32,95%CI:-0.58--0.05,P=0.02),day 3(SMD=-0.48,95%CI:-0.78--0.17,P=0.002)and day 7(SMD=-1.06,95%CI:-1.89--0.23,P=0.01).The edema scores on postoperative day 3(SMD=-0.54,95%CI:-0.81--0.26,P=0.0001),day 7(SMD=-0.98,95%CI:-1.89--0.08,P=0.03)and day 14(SMD=-0.46,95%CI:-0.91--0.02,P=0.04)were also significantly reduced.Conclusion Topical application of Chinese medicinal ointment can promote wound healing after MMH for mixed hemorrhoids,and effectively relieve postoperative pain and local edema.However,limited by the quantity and quality of included studies,the above conclusions still need to be verified by more high-quality,large-sample RCTs.