中药溻渍法治疗糖尿病足溃疡的系统评价和Meta分析  

Systematic evaluation and Meta-analysis of the treatment of diabetic foot ulcer with external medicinal liquid application of Chinese herbs

作　　者：董学宇 李友山[1] 谢存香 陈润铭 安琪 张锦楠 陈宇欢 张硕 Dong Xueyu;Li Youshan;Xie Cunxiang;Chen Runming;An Qi;Zhang Jinnan;Chen Yuhuan;Zhang Shuo(Department of Peripheral Vascular,Dongzhimen Hospital Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京中医药大学东直门医院周围血管科,北京100700

出　　处：《血管与腔内血管外科杂志》2023年第7期781-787,共7页Journal of Vascular and Endovascular Surgery

基　　金：国家自然科学基金面上项目(81973849)。

摘　　要：目的系统评价中药溻渍法应用于糖尿病足溃疡的临床疗效。方法通过计算机系统性检索中国知网、维普、SinoMed、PubMed、the Cochrane Library、Embase等数据库中公开发表的关于中药溻渍法治疗糖尿病足溃疡临床疗效的随机对照研究,检索时限从建库至2021年3月5日,提取相关数据并评价纳入研究的偏倚风险,应用Review Manager 5.3软件进行Meta分析和系统评价。结果共纳入16篇文献,包括1325例糖尿病足溃疡患者,其中,试验组673例,对照组652例。Meta分析结果显示,试验组患者的伤口显愈率明显高于对照组患者,差异有统计学意义(OR=0.25,95%CI:0.19~0.31,P﹤0.01);有效率明显高于对照组患者,差异有统计学意义(OR=4.27,95%CI:2.94~6.22,P﹤0.01);创面愈合时间明显短于对照组患者,差异有统计学意义(RR=-8.82,95%CI:-13.88~-2.56,P=0.004);C反应蛋白水平明显低于对照组患者,差异有统计学意义(RR=-3.19,95%CI:-4.15~-2.24,P﹤0.01)。通过Egger's法检测发表偏倚,结果显示,有效率存在发表偏倚风险。结论中药溻渍法可以有效提高糖尿病足溃疡创面的有效率和显愈率,缩短创面愈合时间,减轻炎症反应。Objective To systematically evaluate the clinical efficacy of external medicinal liquid application of Chinese herbs in the treatment of diabetic foot ulcer.Method The databases of China National Knowledge Infrastructure,VIP,SinoMed,PubMed,the Cochrane Library and Embase were searched to collect the clinical randomized controlled trial of clinical efficacy of external medicinal liquid application of Chinese herbs in the treatment of diabetic foot ulcer from establishment of databases to March 5,2021,the data were extracted and bias risks of studies were included,and Review Manager 5.3 software was used for Meta-analysis and systematic evaluation.Result A total of 16 articles and 1325 patients with diabetic foot ulcers were enrolled,including 673 patients in the experiment group and 652 patients in the control group.Meta-analysis showed that the wound healing rate of the experimental group was significantly higher than that of the control group(OR=0.25,95%CI:0.19-0.31,P<0.01);the effective rate of the experimental group was significantly higher than that of the control group(OR=4.27,95%CI:2.94-6.22,P<0.01);the wound healing time was significantly shorter than that of the control group(RR=-8.82,95%CI:-13.88--2.56,P<0.004);C-reactive protein level was significantly lower than that in the control group(RR=-3.19,95%CI:-4.15--2.24,P<0.01).The Egger's method was used to detect publication bias,and the results showed that there was publication bias risk for effective rate.Conclusion The external medicinal liquid application of Chinese herbs can effectively improve the effective rate and healing rate of diabetic foot ulcer wounds,and shorten the wound healing time and reduce inflammation.

关 键 词：中药溻渍法 糖尿病足溃疡 临床疗效 系统评价 META分析 

分 类 号：R543[医药卫生—心血管疾病]