中医药治疗对糖尿病性视网膜病变患者血液流变学指标影响的Meta分析  

Meta analysis on the influence of traditional Chinese medicine treatment for the hemorheology indexes of patients with diabetic retinopathy

作　　者：陈秋野[1] 马燕云[1] 唐红[1] 

机构地区：[1]上海中医药大学附属龙华医院,上海200032

出　　处：《中国医药导报》2017年第21期175-180,184,共7页China Medical Herald

基　　金：上海中医药大学预算内项目(自然科学类)(2016YSN38)

摘　　要：目的运用Meta分析方法比较中医药治疗与单纯西医治疗对糖尿病性视网膜病变患者血液流变学指标的影响。方法检索Pub Med、Medline、CBM disc、Cochrane图书馆、CNKI、VIP、万方和中国优秀博硕士学位论文全文数据库、学术会议论文集等,检索年限为2000年1月~2016年10月。全面收集相关临床随机对照研究,对纳入的文献进行质量评价与数据提取,采用Revman5.3软件进行Meta分析。结果共纳入26篇临床随机对照研究,共2421例患者,试验组1307例,对照组1114例。试验组患者的全血高切黏度(200/s)(SMD=-0.63,95%CI:-0.91^-0.34,P<0.01)、全血低切黏度(5/s)(WMD=-0.76,95%CI:-1.02^-0.50,P<0.01)、血浆黏度(SMD=-0.62,95%CI:-1.02^-0.22,P=0.002)、纤维蛋白原(SMD=-0.67,95%CI:-0.80^-0.54,P<0.01)、红细胞聚集指数(SMD=-0.96,95%CI:-1.46^-0.47,P=0.0001)明显低于对照组,眼底改变疗效(RR=1.22,95%CI:1.17~1.28,P<0.01)、中医证候疗效(RR=1.55,95%CI:1.18~2.03,P=0.002)明显优于对照组。两组全血中切黏度(30/s)比较差异无统计学意义(MD=-1.22,95%CI:-2.66~0.21,P=0.10)。敏感性分析显示结果稳定可靠。结论中医药治疗能够降低糖尿病性视网膜病变患者全血高切黏度(200/s)、全血低切黏度(5/s)、血浆黏度、纤维蛋白原、红细胞聚集指数,提高眼底改变疗效、中医证候疗效,其作用均优于单纯西医治疗,对全血中切黏度(30/s)没有影响。本次分析提示,中医药治疗对糖尿病性视网膜病变有一定疗效,但研究方法学质量有待进一步提高,需要更多高质量的随机双盲对照试验加以证实。Objective To compare the influence of traditional Chinese medicine treatment and single western medicine treatment for the hemorheology indexes of patients with diabetic retinopathy by meta analysis. Methods The databases of Pub Med, Medline, CBM disc, Cochrane library, CNKI, VIP, Wanfang, China Master＇s Theses Full-text Database and proceedings of the academic conference were retrieved. The retrieval time limit was from January 2000 to October2016. The related clinical randomized controlled trials were researched, and the enrolled literatures were taken quality assessment and data extraction, and Revman5.3 software was used to take Meta analysis. Results In total, 26 clinical randomized controlled trials and 2421 patients were enrolled, with 1307 cases in experimental group and 1114 cases in control group. The levels of whole high blood viscosity（200/s）（SMD =-0.63, 95%CI：-0.91--0.34, P〈0.01）, whole low blood viscosity（5/s）（WMD =-0.76, 95%CI：-1.02--0.50, P〈0.01）, plasma viscosity（SMD =-0.62, 95%CI：-1.02--0.22, P = 0.002）, fibrinogen（SMD =-0.67, 95%CI：-0.80--0.54, P〈0.01）, red blood cell aggregation index（SMD =-0.96, 95% CI：-1.46--0.47, P = 0.0001） in the experimental group were significantly lower than those of control group, the fundus changing curative effect（RR = 1.22, 95%CI： 1.17-1.28, P〈0.01） and TCM syndrome curative effect（RR = 1.55, 95% CI： 1.18-2.03, P =0.002） were significantly better than those of control group. The whole middle blood viscosity（30/s） between two groups had no statistically significant difference（MD=-1.22, 95% CI：-2.66-0.21, P = 0.10）. Sensitivity analysis showed that the results were stable and reliable.Conclusion Traditional Chinese medicine treatment can reduce the whole high blood viscosity（200/s）, whole low blood viscosity（5/s）, plasma viscosity, fibrinogen, erythrocyte aggregation index of patients with diabetic retinopathy, and improve the fundus changing curative effect and TCM syndrome curative effect

关 键 词：糖尿病性视网膜病变 中医药治疗 META分析 血液流变学 

分 类 号：R774.1[医药卫生—眼科]