高压氧辅助治疗糖尿病周围神经病变临床效果及安全性的meta分析  

A meta-analysis of the clinical efficacy and safety of hyperbaric oxygen in the treatment of diabetic peripheral neuropathy

作　　者：黄楚君[1] 丁美祝[1] 黄皓月[1] 胡佩欣 武健 张广清 HUANG Chujun;DING Meizhu;HUANG Haoyue;HU Peixin;WU Jian;ZHANG Guangqing(The Second Clinical Medical College,Guangzhou University of Chinese Medicine,Guangdong Province,Guangzhou510120,China;the Office,Nanfang Hospital of Southern Medical University,Guangdong Province,Guangzhou510515,China)

机构地区：[1]广州中医药大学第二临床医学院,广东广州510120 [2]南方医科大学南方医院办公室,广东广州510515

出　　处：《中国医药导报》2020年第4期82-88,93,F0004,共9页China Medical Herald

基　　金：“十二五”国家科技支撑计划课题（2015BAI04B09）;广东省中医院护理专项立项课题（YN2019HL06）

摘　　要：目的探讨高压氧在糖尿病周围神经病变辅助治疗中的临床效果及安全性。方法检索Cochrane、PubMed、EMBase、CNKI、Wanfang、VIP数据库,筛选从建库至2019年4月报道的高压氧辅助治疗糖尿病周围神经病变的随机对照试验。经2名研究者筛选文献,提取资料与评价文献质量后,采用RevMan 5.2软件对试验中有效率、神经传导速度分别进行meta分析。结果最终共纳入16篇文献,共包括1644例患者,其中试验组836例,对照组808例。meta分析结果显示:试验组和对照组的总有效率[OR=7.97,95%CI(3.95,16.11),P<0.00001]、运动神经传导速度[MD正中神经=5.51,95%CI(3.78,7.25),P<0.00001;MD尺神经=4.49,95%CI(2.20,6.78),P=0.0001;MD腓神经=5.67,95%CI(4.18,7.16),P<0.00001;MD胫神经=3.13,95%CI(1.22,5.05),P=0.001]、感觉神经传导速度[MD正中神经=3.25,95%CI(1.51,4.99),P=0.0003;MD尺神经=7.57,95%CI(2.50,12.64),P=0.003;MD腓神经=4.42,95%CI(3.70,5.14),P<0.00001;MD胫神经=2.46,95%CI(0.64,4.28),P=0.008]比较,差异有统计学意义;试验组出现8例不良事件与副作用,包括轻微疼痛、耳痛、耳鸣、头晕,但损伤较轻,对照组未出现。结论高压氧辅助治疗能提高糖尿病周围神经病变患者治疗有效率,增快神经传导速度,不良事件与副作用少且损伤较轻,是一种安全、有效的方法。Objective To investigate the clinical effect and safety of hyperbaric oxygen in the adjuvant treatment of diabetic peripheral neuropathy.Methods Cochrane,PubMed,EMBase,CNKI,Wanfang and VIP databases were searched to screen randomized controlled trials of hyperbaric oxygenation in the treatment of diabetic peripheral neuropathy reported from the establishment of the database to April 2019.After literature screening,data extraction and literature quality evaluation by two researchers,the meta-analysis of effective rate and nerve conduction velocity was taken by RevMan 5.2 software.Results A total of 16 articles including 1644 patients were included,including 836 in the experimental group and 808 in the control group.The results of meta-analysis showed that the total effective rate[OR=7.97,95%CI(3.95,16.11),P<0.00001,motor nerve conduction velocity[MDmedian nerve=5.51,95%CI(3.78,7.25),P<0.00001;MDulnar nerve=4.49,95%CI(2.20,6.78),P=0.0001;MD peroneal nerve=5.67,95%CI(4.18,7.16),P<0.00001;MDtibial nerve=3.13,95%CI(1.22,5.05),P=0.001];sensory nerve conduction velocity[MDmedian nerve=3.25,95%CI(1.51,4.99),P=0.0003;MDulnar nerve=7.57,95%CI(2.50,12.64),P=0.003;MDperoneal nerve=4.42,95%CI(3.70,5.14),P<0.00001;MDtibial nerve=2.46,95%CI(0.64,4.28),P=0.008]between the experimenttal group and control group,the differences were statistically significant.There were 8 adverse events and side effects in the experimental group,including mild pain,earache,tinnitus,and dizziness,but the injuries were minor,and none in the control group.Conclusion Hyperbaric oxygen-assisted therapy is a safe and effective method,which can improve the therapeutic efficiency of diabetic peripheral neuropathy patients,increase the nerve conduction velocity,reduce adverse events and side effects,and reduce injury.

关 键 词：高压氧 糖尿病周围神经病变 随机对照试验 META分析 

分 类 号：R587.2[医药卫生—内分泌]