复方血栓通胶囊、复方丹参滴丸、芪明颗粒、和血明目片、明目地黄丸和双丹明目胶囊联合羟苯磺酸钙改善非增殖期糖尿病视网膜病变疗效差异的网状Meta分析  

A Network Meta-Analysis of Oral Chinese Patent Xueshuantong Capsules,Danshen Dropping Pills,Qiming Granules,Hexuemingmu Tablets,Mingmudihuang Pills,and Shuangdanmingmu Capsules Combined with Calcium Dobesilate to Improve Non-Proliferative Diabetic Retinopathy

作　　者：田筱婵 魏军平[2] 张旭明 谢雁鸣[1] TIAN Xiaochan;WEI Junping;ZHANG Xuming;XIE Yanming(Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences,Beijing 100700;Guang’anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053)

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]中国中医科学院广安门医院,北京100053

出　　处：《中药药理与临床》2024年第12期91-99,共9页Pharmacology and Clinics of Chinese Materia Medica

基　　金：国家中医药管理局2021岐黄学者支持项目(编号: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(编号:国家中医药人教函[2022]75)。

摘　　要：目的:运用网状Meta分析方法,评价复方血栓通胶囊、复方丹参滴丸、芪明颗粒、和血明目片、明目地黄丸和双丹明目胶囊联合羟苯磺酸钙改善非增殖期糖尿病视网膜病变(NPDR)的疗效及安全性。方法:计算机检索Web of Science、The Cochrane Library、Pubmed、Embase、CNKI、CBM、VIP、WanFang Data数据库,检索自建库到2022年11月20日口服中成药联合羟苯磺酸钙治疗非增殖期糖尿病视网膜病变的随机对照试验(RCT),采用Cochrane偏移风险评价工具进行偏移风险评价,使用R语言进行数据统计分析。结果:最终纳入38篇文献,共计3880例患者。试验组共涉及6种中成药,从总有效率、眼底病变(出血面积、黄斑厚度、视野灰度值和血管瘤体积)、视力、VEGF(血管内皮因子)和糖化血红蛋白(HbA1c)8个结局指标进行评价。Meta分析结果显示:与单用羟苯磺酸钙相比,提高总有效率方面,联合复方血栓通胶囊疗效最显著;缩小出血斑面积方面,联合双丹明目胶囊疗效最显著;降低黄斑厚度方面,联合复方丹参滴丸疗效最显著;缩小血管瘤体积方面,联合和血明目片疗效最显著且显著优于联合其他中成药;缩小视野灰度值方面,双丹明目胶囊疗效最显著;提高视力方面,仅联合芪明颗粒疗效显著;降低VEGF方面,联合双丹明目胶囊疗效最显著,其次为明目地黄丸,且两者疗效均显著优于其他中成药;降低糖化血红蛋白方面,联合各中成药疗效均不显著;联合中成药对不良反应发生率影响不大。结论:中成药联合羟苯磺酸钙治疗可以提高非增殖期糖尿病视网膜病变的疗效,但对血糖的改善效果不显著。鉴于纳入文献数量较少和质量较低,累计排序结果还有待进一步验证。Objective:To evaluate the efficacy and safety of Xueshuantong Capsules,Danshen Dropping Pills,Qiming Granules,Hexuemingmu Tablets,Mingmudihuang Pills,and Shuangdanmingmu Capsules combined with calcium dobesilate in the treatment of non-proliferative diabetic retinopathy(NPDR)via network meta-analysis.Methods:Web of Science,Cochrane Library,Pubmed,Embase,CNKI,CBM,VIP,and Wanfang Database were searched for randomized controlled trials(RCTs)of oral Chinese patent medicine combined with calcium dobesilate in the treatment of NPDR from database establishment to November 20,2022.The Cochrane offset risk assessment tool was used to assess the offset risk of included studies,and the R language was used to analyze the data.Results:A total of 38 pieces of literature were selected,involving 3880 patients and six kinds of Chinese patent medicine.Eight outcome indexes including total effective rate,fundus lesions(bleeding area,macular thickness,visual field gray value,and hemangioma volume),visual acuity,vascular endothelial factor(VEGF),and glycosylated hemoglobin(HbA1c)were evaluated.The results of the meta-analysis are as follows:Compared with calcium dobesilate used independently,calcium dobesilate combined with Xueshuantong(血栓通)Capsules has the best efficacy in improving the total effective rate.Calcium dobesilate combined with Shuangdanmingmu(双丹明目)Capsules has the best efficacy in reducing the area of blood spots,and calcium dobesilate combined with Danshen(丹参)Dropping Pills has the best effect in reducing macular thickness.Calcium dobesilate combined with Hexuemingmu(和血明目)Tablets has the best effect in reducing the volume of angioma,which is significantly better than that combined with other Chinese patent medicines.In addition,calcium dobesilate combined with Shuangdanmingmu Capsules has the best effect in reducing the gray value of the visual field.Calcium dobesilate combined with Qiming Granules only has a significant effect in improving visual acuity.Calcium dobesilate combined with Shuang

关 键 词：复方血栓通胶囊 复方丹参滴丸 芪明颗粒 和血明目片 明目地黄丸 双丹明目胶囊 非增殖期糖尿病视网膜病变 贝叶斯网状Meta分析 

分 类 号：R774.1[医药卫生—眼科] R587.2[医药卫生—临床医学]