新型医用敷料治疗糖尿病足溃疡疗效比较的网状Meta分析  

A network meta-analysis of the efficacy of new medical dressings for diabetic foot ulcers

作　　者：周俊丽 王小俊[2] 王海焦[2] 李春[1] Zhou Junli;Wang Xiaojun;Wang Haijiao;Li Chun(School of Nursing,Guangzhou University of Chinese Medicine,Guangzhou 510006,Guangdong Province,China;First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong Province,China)

机构地区：[1]广州中医药大学护理学院,广东省广州市510006 [2]广州中医药大学第一附属医院,广东省广州市510405

出　　处：《中国组织工程研究》2022年第16期2562-2569,共8页Chinese Journal of Tissue Engineering Research

基　　金：广东省教育厅高校特色创新项目(2020KTSCX025),项目负责人:李春;广东省中医药局(20181083),项目负责人:王海焦。

摘　　要：目的:近年来,各种新型医用敷料被用于糖尿病足溃疡的治疗,哪种敷料的疗效最佳尚不明确,因此文章采用网状Meta分析技术,系统评价不同种新型医用敷料治疗糖尿病足溃疡的疗效。方法:计算机检索中国知网、万方数据、维普、中国生物医学文献数据库、PubMed、EMbase、Cochrane Library、Web of Science数据库,检索时间为建库至2020年11月,纳入新型医用敷料对比治疗糖尿病足溃疡的随机对照试验。采用Cochrane系统评价的偏倚风险评价工具对纳入文献进行质量评价,由2名研究者对文献进行筛选并且提取相关资料。采用RevMan 5.3、ADDIS 1.16.6、Stata 14.0软件进行文献质量评价与数据分析。结果:共纳入33项随机对照试验,涉及糖尿病足溃疡患者2 520例,其中10项为低风险偏倚研究,19项为中风险偏倚研究,4项为高风险偏倚研究。网状Meta分析结果显示:(1)在治愈率方面,银离子敷料、表皮生长因子、富血小板血浆、羊膜均优于传统敷料和藻酸盐敷料,富血小板血浆优于银离子敷料,蜂蜜敷料优于传统敷料(P<0.05),概率排名前3位的敷料是富血小板血浆、羊膜、表皮生长因子;(2)在愈合时间方面,银离子敷料、表皮生长因子、富血小板血浆均优于传统敷料和藻酸盐敷料,蜂蜜敷料均优于藻酸盐敷料(P<0.05),概率排名3位的敷料是表皮生长因子、富血小板血浆、银离子敷料。结论:(1)基于33项随机对照试验的结果数据证实,在诸多新型医用敷料中,富血小板血浆、表皮生长因子、羊膜及银离子敷料治疗糖尿病足溃疡的效果均优于其他传统敷料,其中富血小板血浆敷料在提高糖尿病足治愈率方面总体效果最好,表皮生长因子敷料在改善糖尿病足溃疡愈合时间方面总体效果最佳。OBJECTIVE: In recent years, a variety of new medical dressings have been used in the treatment of diabetic foot ulcer, and it is not clear which dressing has the best effect. Therefore, this study used network meta-analysis technology to systematically evaluate the efficacy of different new medical dressings in the treatment of diabetic foot ulcer.METHODS: A computer search was conducted on CNKI, Wanfang Data Knowledge Service Platform, VIP, China Biomedical Literature Database, PubMed, EMbase, Cochrane Library, and Web of Science databases from the database establishment to November 2020. Randomized controlled trials of new medical dressings in the treatment of diabetic foot ulcer were included. The bias risk assessment tool of the Cochrane systematic evaluation was used to evaluate the quality of the included literature. Two researchers screened the literature and extracted relevant data. RevMan 5.3, ADDIS 1.16.6 and Stata 14.0 software were used for literature quality evaluation and data analysis.RESULTS: A total of 33 randomized controlled trials involving 2 520 patients with diabetic foot ulcers were included, 10 of which were low-risk bias, 19 of which were medium-risk bias, and 4 of which were high-risk bias. Network meta-analysis results showed that(1) regarding the cure rate, the silver ion dressings, epidermal growth factor, platelet rich plasma, and amniotic membrane were superior to traditional dressings and alginate dressings;platelet rich plasma was better than that of the silver ion dressings;honey dressing was better than traditional dressings(P < 0.05). A probability results show that the top three dressings was platelet rich plasma, amniotic membrane, and epidermal growth factor.(2) In terms of healing time, silver ion dressings, epidermal growth factor and platelet rich plasma were all better than traditional dressings and alginate dressings, and honey dressings were all better than alginate dressings(P < 0.05). The probability results showed that epidermal growth factor, platelet rich plasma a

关 键 词：生物材料 糖尿病足 溃疡 新型医用敷料 富血小板血浆 表皮生长因子 随机对照试验 网状Meta分析 

分 类 号：R459.9[医药卫生—治疗学] R319[医药卫生—临床医学]