基于GRADE系统的蜡疗治疗糖尿病周围神经病变的系统评价  

Effectiveness of wax therapy for diabetic peripheral neuropathy：a systematic review based on GRADE system

作　　者：姜雨婷[1] 田润溪[2] 郝玉芳[1] 韩柳[1] 晏利姣[1] 赵俊强[1] 王晋芳[1] 马睛雅 李学靖[1] 郭海玲[2] Jiang Yuting Tian Runxi Hao Yufang Han Liu Yan Lijiao Zhao Junqiang Wang Jinfang Ma Qingya Li Xuejing Guo Hailing(Nursing School, Beijing University of Chinese Medicine, RNAO of Beijing University of Chinese Medicine, JBI Evidence-based Nursing Excellent Collaboration Center of Beijing University of Chinese Medicine, Beijing 100102, China Nursing Department, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China)

机构地区：[1]北京中医药大学护理学院北京中医药大学加拿大安大略注册护士协会最佳实践指南研究中心(RNAO)北京中医药大学JBI循证护理卓越合作中心,100102 [2]北京中医药大学东直门医院护理部,100700

出　　处：《中华现代护理杂志》2017年第24期3108-3113,共6页Chinese Journal of Modern Nursing

基　　金：北京市中医管理局专项资助项目（JJ2016-51）

摘　　要：目的 系统评价蜡疗法治疗糖尿病周围神经病变的有效性,为糖尿病周围神经病变的治疗及预防提供参考意见.方法 计算机检索Cochrane Library、JBI、PubMed、EMbase、中国生物医学文献数据库（CBM）、中国知网（CNKI）、万方数据知识服务平台（WANFANG DATA）和维普期刊资源整合服务平台（VIP）数据库中有关蜡疗法治疗糖尿病周围神经病变的随机对照试验（RCT）.检索时间限定为各数据库建库至2016年10月1日.由2名研究员按照纳入排除标准独立进行文献筛选和资料提取,并参考Cochrane手册中的质量评价标准对纳入文献进行质量评价,利用Review Manger 5.3分析软件进行Meta分析,使用GRADE Profiler 3.6.1软件进行GRADE评级.结果 最终共纳入8篇原始研究,其中文献质量等级为A级的原始研究数量为3篇,质量等级为B级的原始研究数量为4篇,质量等级为C级的原始研究数量为1篇.Meta分析结果显示,蜡疗能够提高糖尿病周围神经病变患者腓神经的感觉神经传导速度[MD=2.51,95%CI（1.35,3.66）,P〈0.01],经GRADE系统评级,证据体的质量为中等级别.结论 蜡疗可以改善糖尿病周围神经病变的神经传导速度及血液循环流速,能够预防糖尿病足溃疡的发生.但仍然需要大样本、多中心、高质量的研究对本研究结果予以验证.Objective To evaluate the efficacy of wax therapy for diabetic peripheral neuropathy, in order to provide suggestions for treatment and prevention.Methods Cochrane Library, JBI, PubMed, EMbase, CBM, CNKI, WANFANG DATA, VIP were searched by computer from inception to October, 2016 for randomized control trails in wax therapy for diabetic peripheral neuropathy. Two researchers searched and selected articles independently and the quality was assessed in accordance with Cochrane Manual. The articles were analyzed with Review Manager 5.3, and the evidence quality was assessed with GRADE profiler 3.6.1 software.Results A total of 8 randomized controlled trials were included. The number of literature quality grade A of original research is 3, while the number of literature quality grade B of original research is 4,and the number of literature quality grade C of original research is 1. Meta-analysis showed that the sensory nervus peronaeus conduction velocities improved by wax therapy for diabetic peripheral neuropathy patients,[MD=2.51, 95%CI（1.35,3.66）, P〈0.01]. By the GRADE system grading, the evidence quality is moderate.Conclusions The effect of wax therapy for diabetic peripheral neuropathy can improve the sensory nurve conduction velocities and speed of blood circle, so as to prevent ulcer of diabetic feet. Therefore, the clinical curative effects of the therapy require large-sample and high quality studies to confirm.

关 键 词：糖尿病周围神经病变 蜡疗 系统评价 GRADE系统 

分 类 号：R473.5[医药卫生—护理学]