补肾祛瘀法治疗糖尿病认知功能障碍疗效的Meta分析  

Meta-Analysis of the Curative Effect of Tonifying Kidney and Removing Blood Stasis in Treating Diabetic Cognitive Impairment

作　　者：甘盼盼 刘玲 全毅红[2] GAN Pan-pan;LIU Ling;QUAN Yi-hong(Clinical College of Traditional Chinese Medicine of Hubei University of Chinese Medchine,Wuhan Hubei 430065;Wuhan Central Hospital Affiliated to Tongi Medical College,Huazhong University of Science and Technolog,Wuhan Hubei 430014;Department of Encephalopathy,Mfiliated Hospital of Hubei University of Traditional Chinese Medicine,Wuhan Hubei 430061)

机构地区：[1]湖北中医药大学中医临床学院,湖北武汉430065 [2]华中科技大学同济医学院附属武汉市中心医院中医科,湖北武汉430014 [3]湖北中医药大学附属医院脑病科,湖北武汉430061

出　　处：《世界中西医结合杂志》2021年第4期593-598,606,共7页World Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金资助项目(81273648)。

摘　　要：目的系统评价补肾祛瘀法治疗糖尿病认知功能障碍(Diabetic cognitive dysfunction,DCD)的临床疗效及安全性。方法检索中国知网、万方数据库、中国生物医学文献服务系统、Pub Med、EMbase以及Cochrane数据库,检索时间为建库至2020年4月,由2名评价者独立筛选文献、提取资料和评价纳入研究文献质量,运用Rev Man5.3软件进行Meta分析。结果最终纳入9项随机对照试验(RCTs),共649例,其中试验组326例,对照组323例。Meta分析结果显示:与对照组比较,补肾祛瘀法治疗能显著提高临床有效率[RR=1.50,95%CI(1.29~1.73),P <0.000 01],能显著改善Moca量表积分[MD=2.74,95%CI(1.76~3.19),P=0.000 01],能显著改善MMSE量表评分[MD=2.07,95%CI (1.40~2.73),P <0.000 01],能显著改善MQ评分[MD=13.61,95%CI(9.78~17.44),P <0.000 01],对ADL14项量表有显著的改善作用[MD=6.71,95%CI(4.65~8.78),P <0.000 01]。但两组对于改善CDR评分[MD=-0.01,95%CI(-0.08~0.77),P=0.84]及ADL20项评分[MD=-1.07,95%CI(-2.99~0.85),P=0.28]方面差异无统计学意义。结论运用补肾健脾法治疗糖尿病认知功能障碍,可提高临床有效率、改善Moca量表、MMSE量表、MQ量表评分,但纳入文献质量相对偏低且病例数较少,仍需高质量、大样本量RCTs进一步验证。Objective To systematically evaluate the clinical efficacy and safety of tonifying kidney and removing blood stasis in the treatment of diabetic cognitive dysfunction. Methods CNKI database,WANGFANG DATA database,CBM,Pub MEd,Embase and Cochrane database were retrieved from the database establishment to April 2020. Two reviewers independently screened the literature,extracted the DATA and evaluated the inclusion of the bias,and then Rev Man5. 3 was used for Meta analysis. Results Nine randomized controlled trials( RCTs) were included,with a total number of 649 cases,including 326 in the experimental group and 323 in the control group. The results of the meta-analysis showed that the therapeutic effect of tonifying kidney and removing blood stasis was significantly improved compared with the control group( RR = 1. 50,95% CI = 1. 29 ~ 1. 73,P < 0. 000 01). Significantly improved Moca scale integral( MD = 2. 74,95%CI = 1. 76 ~ 3. 19,P = 0. 000 01). MMSE scale scores were significantly improved( MD = 2. 07,95% CI = 1. 40 ~ 2. 73,P <0. 000 01). Significantly improved MQ score( MD = 13. 61,95% CI = 9. 78 ~ 17. 44,P < 0. 000 01). There was a significant improvement in the 14-item adlscale( MD = 6. 71,95% CI = 4. 65 ~ 8. 78,P < 0. 000 01). However,there was no statistical significance in the improved CDR score( MD =-0. 01,95% CI =-0. 08 ~ 0. 77,P = 0. 84) and the ADL20 score( MD =-1. 07,95% CI =-2. 99 ~ 0. 85,P = 0. 28). Conclusion Tonifying kidney and removing blood stasis can improve the clinical efficiency and Moca scale,MMSE scale and MQ scale. However,the quality of the included literature is relatively low and the number of cases is small,so it still needs to be further verified by RCTs with high quality and large sample size.

关 键 词：补肾祛瘀法 糖尿病认知功能障碍 META分析 

分 类 号：R587.2[医药卫生—内分泌]