氧气治疗糖尿病足溃疡疗效的网状Meta分析  

Efficacy of oxygen therapy for diabetic foot ulcers:a network meta-analysis

作　　者：宁蓬 张加兴[1] 曹洪义[1] 杨婧[1] NING Peng;ZHANG Jiaxing;CAO Hongyi;YANG Jing(Department of Endocrine and Metabolism,Chengdu Fifth People’s Hospital(The Second Clinical Medical College,Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine),Geriatric Diseases Institute of Chengdu,Chengdu 611137,P.R.China)

机构地区：[1]成都市第五人民医院(成都中医药大学附属第五人民医院/第二临床医学院)内分泌科/成都市老年疾病研究所,成都611137

出　　处：《中国循证医学杂志》2025年第3期294-302,共9页Chinese Journal of Evidence-based Medicine

基　　金：成都市第五人民医院科研基金(编号:GSPZX2022-19)。

摘　　要：目的 系统评价氧气治疗糖尿病足溃疡的疗效。方法 计算机检索PubMed、Embase、Cochrane Library、CNKI、WanFang Data和VIP数据库,搜集不同氧气治疗对糖尿病足溃疡疗效的随机对照试验(RCT),检索时限均从建库至2024年4月1日。由2位研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用R软件和GraphPad Prism进行统计分析和绘图。结果 共纳入61项RCT,包括4 306个糖尿病足溃疡,纳入的氧气治疗主要为高压氧、局部氧和臭氧。累积排名曲线下面积(SUCRA)显示,高压氧治疗糖尿病足溃疡在愈合率、面积减少率和愈合时间上排名均最高(SUCRA分别为0.957、0.868、0.869),但同时高压氧治疗在截肢率和不良事件发生率上排名也较高(SUCRA分别为0.616和0.718)。亚组分析显示,不同发表语言和治疗持续时间的高压氧治疗亚组在面积减少率上排名仍然最高。结论 高压氧治疗糖尿病足溃疡在愈合率、面积减少率、愈合时间上有优势,但截肢率和不良事件发生率同样较高。受纳入研究数量和质量限制,上述结论尚需开展更多高质量研究予以验证。Objective To systematically review the efficacy of oxygen therapy for diabetic foot ulcers(DFUs).Methods The PubMed,Embase,Cochrane Library,CNKI,WanFang Data,and VIP databases were electronically searched to collect randomized controlled trials(RCT)on the efficacy of different oxygen therapies for DFUs from inception to April 1,2024.Two reviewers independently screened the literature,extracted data,and assessed the risk of bias of the included studies.Statistical analysis was performed using R software,and GraphPad Prism was used for graphical representations.Results A total of 61 RCTs involving 4306 DFUs cases were included in the analysis.The oxygen therapies examined primarily included hyperbaric oxygen,topical oxygen,and ozone therapy.The surface under the cumulative ranking curve(SUCRA)indicated that hyperbaric oxygen therapy ranked highest for healing rate,area reduction rate,and healing time(SUCRA values were 0.957,0.868,and 0.869,respectively).However,hyperbaric oxygen therapy also ranked higher for amputation rate and adverse events(SUCRA values were 0.616 and 0.718,respectively).Further subgroup analysis revealed that hyperbaric oxygen therapy maintained the highest ranking in area reduction rate across subgroups defined by publication language and treatment duration.Conclusion Hyperbaric oxygen therapy has advantages in terms of healing rate,area reduction rate,and healing time for DFUs,but it is also associated with higher amputation rates and adverse events.Due to the limited quantity and quality of the included studies,more high-quality studies are needed to verify the above conclusion.

关 键 词：糖尿病足溃疡 高压氧 局部氧 臭氧 疗效 网状Meta分析 随机对照试验 

分 类 号：R47[医药卫生—护理学]