EFFICACY OF TAOHONG SIWU DECOCTION IN TREATING FEMORAL HEAD NECROSIS: A META-ANALYSIS WITH IMPLICATIONS FOR ATHLETIC HEALTH

Abstract

Objective: This meta-analysis investigates the efficacy of Taohong Siwu Decoction (TSD) in treating femoral head necrosis (FHN), particularly focusing on its implications for athletes who may be at increased risk due to intensive physical activity. Methods: We conducted a comprehensive search of relevant databases for studies on TSD in the treatment of FHN, ultimately including five studies that met our stringent inclusion criteria. Data on publication details, sample sizes, intervention and control schemes, bone mineral density (BMD), osteoprotegerin (OPG), inflammatory markers (IL-6, CRP, TNF-α), hypoxia-inducible factor-1α (HIF-1α), and vascular endothelial growth factor (VEGF) were extracted and analyzed using RevMan V.5.3 software. Depending on the heterogeneity among studies, either a random-effects or fixed-effects model was applied. Results: The meta-analysis included both human subjects and FHN rabbit models across the studies. Results indicated that subjects treated with TSD exhibited significant improvements in BMD and OPG levels and reduced inflammatory markers (IL-6, TNF-α, and CRP) compared to controls (P<0.05). However, HIF-1α levels showed no significant differences between groups (P>0.05), while VEGF levels were significantly higher in the treatment group (P<0.05). The analysis also highlighted considerable publication bias in the reporting of TNF-α and VEGF levels. Conclusions: TSD demonstrates substantial therapeutic benefits in managing FHN by improving BMD, enhancing OPG levels, and mitigating inflammatory responses. These findings are particularly relevant for athletes, who may benefit from TSD’s protective effects on bone health and its anti-inflammatory properties, potentially aiding in quicker recovery and prolonged sports engagement. Further research is recommended to explore the long-term benefits and mechanisms of TSD in athletic populations, especially those at high risk for FHN.