Efficacy and safety of safflower yellow combined with low molecular weight heparin in preventing deep vein thrombosis after orthopedic surgery: a systematic review and meta-analysis

This systematic review and meta-analysis aims to evaluate the efficacy and safety of safflower yellow (SY) combined with low molecular weight heparin (LMWH) in preventing deep vein thrombosis (DVT) after orthopedic surgery. We conducted a comprehensive investigation of PubMed, EMbase, Cochrane Library, CNKI, VIP, and Wanfang databases to identify randomized controlled trials (RCTs) from January 2000 to March 2024. These trials compared the efficacy of SY combined with LMWH versus LMWH alone in preventing post-surgical DVT. Primary outcomes were the incidence of DVT, activated partial thromboplastin time (APTT), and prothrombin time (PT). The methodological quality of included studies was assessed using the modified Jadad scale. The meta-analysis, conducted with using RevMan 5.3 and STATA, employed fixed or random-effects models depending on heterogeneity assessments. It calculated risk ratios (RR) for DVT incidence and mean differences for APTT/PT, while also evaluating robustness and publication bias. Significance thresholds were set at P < 0.05 and P < 0.1, respectively. Our analysis included eight RCTs involving 624 patients. The meta-analysis revealed that the combination of SY and LMWH significantly reduced the incidence of DVT (RR: 0.29, 95% CI: 0.16-0.52) compared to LMWH alone, with no difference in adverse reaction rate. Additionally, the combination therapy demonstrated improved APTT and PT profiles. The combination of SY and LMWH is more effective than LMWH alone for preventing DVT post orthopedic surgery, offering a promising alternative for thromboprophylaxis in these patients.