Progress of blood-activating and blood-stasis-removing herbs combined with shoulder arthroscopy in repairing rotator cuff injury: a meta-analysis

OBJECTIVE: To assess the differences in clinical efficacy of different blood-activating and blood-stasis-removing Chinese herbal formulas combined with shoulder arthroscopy for repairing rotator cuff injuries by reticulation meta-analysis, with a view to providing evidence-based basis for clinical diagnosis and treatment. METHODS: Relevant randomized controlled trials were searched in CNKI, Wanfang VIP, Wipro, PubMed, Web Of Science, and Cochrane Library, and the retrieval time was from the construction of the library to August 2023. Net meta-analysis was performed using RevMan 5.4, Stata 18.0 software. Results: A total of 9 RCTs were included in the literature, involving 558 patients with rotator cuff injury. Reticulated meta-analysis showed that Taohong Siwu decoction (RR=1.19 ,95%CI (1.00,1.41)), Buyang Huanwu decoction (RR=1.32, 95%CI (1.11,1.57)) were superior to simple arthroscopy group in terms of improving the clinical efficacy rate, FuYuan Huoxue decoction (RR=1.13 95% CI (0.97,1.32)) did not differ statistically from the simple arthroscopy group; the area under the curve of the cumulative probability plot was in the following order: Taohong Siwu decoction > Buyang Huanwu decoction > FuYuan Huoxue decoction > simple arthroscopy group. In terms of improving postoperative UCLA scores, Buyang Huanwu decoction (MD=4.56,95% CI (3.97,5.15)), Shentong Zhuyu decoction (MD=1.33,95%CI (0.28,2.38)), Huoxue Lishui decoction (MD=1.53,95%CI (0.82, 2.23)), Shujin Huoxue decoction (MD=3.09,95%CI(1.71,4.47)), Huoxue Zhitong decoction (MD=1.75,95%CI(0.92,2.58)), and Fuyuan Huoxue decoction (MD=4.57,95%CI(2.28,6.86)) were superior to the simple arthroscopy group; the cumulative probability plot area under the curve was ranked as follows: Buyang Huanwu decoction > Fuyuan Huoxue decoction >Shujin Huoxue decoction >Huoxue Zhitong decoction >Huoxue Lishui decoction >Shentong Zhuyu decoction > simple arthroscopy group. CONCLUSION: When repairing rotator cuff injuries under shoulder arthroscopy, the combined use of blood-activating and blood- stasis-removing traditional Chinese medicines can improve the patients' postoperative symptoms; among them, Taohong Siwu decoction and Buyang Huanwu decoction have certain advantages.