不同中药注射液治疗糖尿病周围神经病变的网状Meta分析  

A Network Meta-analysis of Different Chinese Medicine Injections in Treating Diabetic Peripheral Neuropathy

作　　者：谢文莹 张晨[1] 辛竞妍 李文慧 张涛静[2] XIE Wenying;ZHANG Chen;XIN Jingyan;LI Wenhui;ZHANG Taojing(Beijing University of Chinese Medicine,Beijing 100029,China;Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学东方医院,北京100078

出　　处：《世界中医药》2024年第8期1114-1128,共15页World Chinese Medicine

基　　金：国家自然科学基金项目(81774223)。

摘　　要：目的:运用网状Meta分析不同中药注射液治疗糖尿病周围神经病变(DPN)的疗效和安全性。方法:基于PubMed、Cochrane Library、EMbase、Web of Science、国家知识基础设施数据库(CNKI)、中文科技期刊数据库(CCD)、中国学术期刊数据库(CSPD)、中国生物医学文献数据库(CBM),检索中药注射液治疗DPN的随机对照试验(RCTs),将临床总有效率作为主要结局指标,正中和腓总的感觉神经传导速度(SCV)及运动神经传导速度(MCV)、空腹血糖(FBG)及不良反应作为次要结局指标。采用Cochrane评价手册5.3风险偏倚评估工具进行质量评价及RevMan 5.4.1及Stata 17软件进行数据分析。结果:共纳入76项RCTs,包括6 108例患者,11种中药注射液。网状Meta分析结果显示,丹参多酚酸盐注射液联合西药在提高临床总有效率和改善FBG水平方面疗效最佳;苦碟子注射液联合西药在改善正中神经及腓总神经的SCV、正中神经MCV方面疗效最佳;血塞通注射液联合西药在改善腓总神经MCV方面疗效最佳;在安全性方面,中药注射液联合西药与单纯西药治疗比较差异无统计学意义。结论:中药注射液联合西药与单纯西药治疗比较可提高DPN临床疗效,且未增加不良反应的发生。Objective:To evaluate the efficacy and safety of different Chinese medicine injections for diabetic peripheral neuropathy by a network meta-analysis.Methods:PubMed,Cochrane Library,EMbase,Web of Science,China National Knowledge Infrastructure(CNKI),Chinese Citation Database(CCD),China Science Periodical Database(CSPD),and China Biology Medicine(CBM) were searched for the randomized controlled trials(RCTs) of Chinese medicine injections in treating diabetic peripheral neuropathy.The clinical total response rate was regarded as the main outcome indicator,while the sensory conduction velocity(SCV) of median nerve and peroneal nerve,motor conduction velocity(MCV) of median nerve and peroneal nerve,fasting blood glucose(FBG),and adverse reactions were taken as the secondary outcome indicators.The quality of the included studies was evaluated by Cochrane Handbook 5.3.RevMan 5.4.1 and Stata 17 were used to analyze the data.Results:A total of 76 RCTs were included,involving 6 108 patients and 11 Chinese medicine injections.The network meta-analysis yielded the following results.In terms of improving the clinical total response rate and FBG,Salvianolate Injection combined with Western medicine had the best effect.Kudiezi Injection combined with Western medicine was the best in improving the SCV of median nerve and peroneal nerve and the MCV of median nerve.Xuesaitong Injection combined with Western medicine had the best effect in improving the MCV of peroneal nerve.The incidence of adverse reactions showed no statistical difference between Chinese medicine injections combined with Western medicine and Western medicine alone.Conclusion:Compared with Western medicine alone,Chinese medicine injections combined with Western medicine demonstrated improved effect without increasing the occurrence of adverse reactions in the treatment of diabetic peripheral neuropathy.

关 键 词：中药注射液 糖尿病周围神经病变 网状Meta分析 系统评价 临床总有效率 神经传导速度 安全性 随机对照试验 

分 类 号：R289.5[医药卫生—方剂学]