针药治疗糖尿病视网膜病变的Meta分析  

A Meta-analysis of acupuncture plus drug therapy for diabetic retinopathy

作　　者：徐正辉 张俊丽 华飞[1] XU Zhenghui;ZHANG Junli;HUA Fei

机构地区：[1]苏州大学附属第三医院,江苏常州213000

出　　处：《中医临床研究》2023年第24期49-54,共6页Clinical Journal Of Chinese Medicine

基　　金：常州市社会发展科技支撑项目(CE20215044)。

摘　　要：目的:系统评价中医针灸及针药治疗对于糖尿病视网膜病变(Diabetic Retinopathy,DR)的效果,评估其临床安全性和可行性,为针灸或针药治疗DR的推广和应用提供循证依据。方法:通过主题词等内容全面搜索Pubmed、Cochrane Library、中国知网、维普中文科技期刊数据库及万方数据库,搜索时间为建库至2022年3月21日,对照组仅常规西医治疗DR,试验组除常规治疗外加予针灸或针药治疗。用R-4.1.0软件统计分析并绘制森林图,从而对针药治疗DR总有效率、视力改变等进行Meta分析。文献质量评价的依据为Cochrane Handbook 5.1.0。依次删除每一篇文献进行Meta分析,进而评价研究结果的稳定性。将纳入文献制成漏斗图以评价发表偏倚。结果:共检索到文献2044篇,在此基础上,排除重复文献、综述性文献、评论、病例汇报、非人体试验及具有明显设计不足的文献后,最终对共计18篇文献进行Meta分析。试验组样本量为915,对照组样本量为886。结果显示针灸治疗DR总有效率较对照组明显提高[相对危险度(Risk Rate,RR)=1.25,95%置信区间(Confidence Interval,CI)(1.19,1.31),P<0.0001],患者DR患眼视力水平较对照组显著改善[均数差(Mean Difference,MD)=0.11,95%CI((0.00,0.22),Z=1.95,P=0.05]。敏感度分析提示Meta分析的结果稳定。结论:综合目前研究,西医联合针灸或针药治疗DR疗效显著优于单用西医常规治疗,结合针灸或针药等中医手段治疗DR具有临床应用价值。Objective:To systematically evaluate the effect of traditional Chinese medicine acupuncture treatment and drug therapy for diabetic retinopathy(DR),evaluate the clinical safety and feasibility,and provide evidence-based basis for the promotion and application of acupuncture treatment and drug therapy of DR.Methods:Pubmed,Cochrane Library,China National Knowledge Infrastructure combination of acupuncture treatment and drug therapy and Western medicine.R-4.1.0 was used for drawing forest plot and statistical analysis of total efficiency and vision.The basis of literature quality evaluation was performed by Cochrane Handbook 5.1.0.Each literature was excluded in turn to evaluate the stability of the results.The funnel plot made from the included literature was used to evaluate the publication bias.Results:A total of 2044 papers were retrieved.Eventually 18 papers were included after excluding repetitive literature,literature reviews,comments,case reports,animal experiments and experiments with obvious insufficient design.There were 915 individuals in the experimental group and 886 individuals in the control group.According to the meta-analysis,the combination of acupuncture treatment and drug therapy significantly improved the total efficiency[RR=1.25,95%CI(1.19,1.31),P<0.0001]and vision[MD=0.11,95%CI(0.00,0.22),Z=1.95,P=0.05]compared with the control group.After verification,the results were stable.Conclusion:All present evidence suggests that the combination of acupuncture treatment and drug therapy is beneficial to DR on the basis of conventional Western medicine.The combination of acupuncture treatment and drug therapy and Western medicine has clinical value in treating DR.

关 键 词：针药并用 糖尿病视网膜病变 糖尿病 META分析 系统评价 

分 类 号：R255.4[医药卫生—中医内科学]