口服中成药治疗2型糖尿病周围神经病变的网状Meta分析  

Network Meta-analysis of oral Chinese patent medicine in treatment of type 2 diabetic peripheral neuropathy

作　　者：李纪新 张旭明 王文茹 邱林杰 张晋[2] 谢雁鸣[1] LI Ji-xin;ZHANG Xu-ming;WANG Wen-ru;QIU Lin-jie;ZHANG Jin;XIE Yan-ming(Institute of Clinical Basic Medicine of Chinese Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China;Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China)

机构地区：[1]中国中医科学院中医临床基础医学研究所,北京100700 [2]中国中医科学院西苑医院,北京100091

出　　处：《中草药》2023年第17期5684-5702,共19页Chinese Traditional and Herbal Drugs

基　　金：国家中医药管理局2021歧黄学者支持项目(国家中医药人教函[2022]6);谢雁鸣全国名老中医药专家传承工作室建设项目(国家中医药人教函[2022]75)。

摘　　要：目的运用网状Meta分析方法,评价临床常用口服中成药治疗2型糖尿病周围神经病变的有效性及安全性。方法计算机检索中国知网(CNKI)、万方(Wanfang)、维普(VIP)、中国生物医学文献服务系统(CBM)、PubMed、Embase、Cochrane Library、Web of Science中有关中成药干预糖尿病周围神经病变的随机对照试验(randomized controlled trial,RCT),时间跨度为建库至2022年11月10日;采用Cochrane偏倚风险评估工具对纳入研究进行质量评价;运用R 4.2.1进行网状Meta分析。结果共纳入57项RCTs,总样本量5200例,涵盖10种口服中成药(木丹颗粒、银丹心脑通软胶囊、通心络胶囊、津力达颗粒、糖脉康颗粒、复方血栓通胶囊、复方丹参滴丸、通脉降糖胶囊、脑心通胶囊、血塞通胶囊)。在改善感觉神经传导速度方面,木丹颗粒+常规治疗(conventional treatment,CT)相对较优;在改善运动神经传导速度方面,通心络胶囊+CT相对较优;在改善氧化应激反应方面,木丹颗粒+CT、复方血栓通胶囊+CT相对较优;在安全性方面,17项研究报道了共计17例不良反应发生,且试验组与对照组间无统计学差异(P>0.05)。结论相比于常规治疗,在其基础上联用中成药治疗2型糖尿病周围神经病变在改善周围神经功能和氧化应激反应方面均有优势,其中木丹颗粒+CT各项疗效结局指标均优于对照组(P<0.05),排名相对靠前,且安全性较高,可能为最佳治疗方案,但由于不同干预措施纳入研究质量和方法学的局限性,所得结论尚需进一步验证。Objective To evaluate the efficacy and safety of commonly used oral Chinese patent medicines in the treatment of type 2 diabetic peripheral neuropathy by network Meta-analysis.Methods Randomized controlled trials(RCTs)of Chinese patent medicine intervention in diabetic peripheral neuropathy were searched in CNKI,Wanfang,VIP,CBM,PubMed,Embase,Cochrane Library and Web of Science from inception to November 10,2022.Cochrane bias risk assessment tool was used to evaluate the quality of the included studies.Network Meta-analysis was conducted using R 4.2.1.Results A total of 57 RCTs involving 5200 patients were included,covering 10 oral Chinese patent medicines[Mudan Granules(木丹颗粒),Yindan Xinnaotong Soft Capsules(银丹心脑通软胶囊),Tongxinluo Capsules(通心络胶囊),Jinlida Granules(津力达颗粒),Tangmaikang Granules(糖脉康颗粒),Compound Xueshuantong Capsules(复方血栓通胶囊),Compound Danshen Dripping Pills(复方丹参滴丸),Tongmai Jiangtang Capsules(通脉降糖胶囊),Naoxintong Capsules(脑心通胶囊),and Xuesaitong Capsules(血塞通胶囊)].The results showed that Mudan Granules+conventional treatment(CT)was relatively better in improving sensory nerve conduction velocity.In terms of improving motor nerve conduction velocity,Tongxinluo Capsules+CT were relatively better;In terms of improving oxidative stress response,Mudan Granules+CT and compound Xueshuantong Capsules+CT were relatively better;In terms of safety,17 studies reported a total of 17 adverse reactions,and there was no statistical difference between the experimental group and the control group(P>0.05).Conclusion Compared with CT,the combination of Chinese patent medicine in the treatment of type 2 diabetic peripheral neuropathy had advantages in improving peripheral nerve function and oxidative stress response.Among them,the efficacy outcome indicators of Mudan Granules+CT were better than those of the control group(P<0.05),ranking relatively high,and the safety is high,which may be the best treatment plan.However,du

关 键 词：中成药 糖尿病周围神经病变 网状Meta分析 随机对照试验 木丹颗粒 银丹心脑通软胶囊 通心络胶囊 津力达颗粒 糖脉康颗粒 复方血栓通胶囊 复方丹参滴丸 通脉降糖胶囊 脑心通胶囊 血塞通胶囊 

分 类 号：R285.64[医药卫生—中药学]