Meta and Trial Sequential Analysis on External Application of Traditional Chinese Medicine Combined with Antibiotics in the Treatment of Lower Limb Erysipelas
ZHOU Shu-yi,LI Ying-xian,LU Wei-qi
Abstract:
Objective To systematically evaluate the clinical efficacy of external application of traditional Chinese medicine (TCM) and antibiotics in the treatment of erysipelas of lower limbs. Methods Randomized controlled trials (RCTs) of external application of TCM and antibiotics in the treatment of erysipelas of lower limbs were searched from January 2011 to July 2021 of establishment of CNKI, VIP, Wanfang, Web of Science, PubMed and EMBASE database. RevMan 5.3 was used for meta-analysis and TSA 0.9 was used for trial sequential analysis (TSA). Results A total of 16 RCTs involving 1165 patients were included. The results of meta-analysis showed that the clinical efficiency of the treatment group was significantly higher than that of the control group [RR=1.15, 95% CI (1.11, 1.21), P<0.001]. The cure time [SMD=-2.65, 95% CI (-3.67, -1.62), P<0.001], pain relief time of affected limb [SMD=-5.18, 95% CI (-5.69, -4.67), P<0.001], swelling relief time[SMD=-2.03, 95% CI (-2.45, -1.61), P<0.001], number of white blood cells after treatment [SMD=0.81, 95% CI (-1.10, -0.53), P<0.001], C-reactive protein [SMD=-1.01, 95% CI (-1.39, -0.63), P<0.001] and neutrophil count [MD=-1.66, 95% CI (-2.22, -1.10), P<0.001] in the treatment group were significantly better than those in the control group. There were no serious adverse reactions in the two groups. TSA showed external application of TCM had definite curative effect on erysipelas of lower limbs, which can eliminate the possibility of false positive. Conclusion External application of TCM in the treatment of erysipelas of lower extremities has good curative effect and less adverse reactions, but more high-quality, multi center, large sample and rigorous RCTs should be carried out in the future to further verify.