推拿疗法治疗肥胖合并2型糖尿病有效性和安全性的Meta分析  

Meta-analysis of the Efficacy and Safety of Tuina Therapy in the Treatment of Obesity Combined with Type 2 Diabetes Mellitus

作　　者：黄延芹[1] 路振凯 王伟[3] 张倩[1] 邓华亮[3] HUANG Yanqin;LU Zhenkai;WANG Wei;ZHANG Qian;DENG Hualiang(Department of Endocrinology,Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250013,China;不详)

机构地区：[1]山东中医药大学附属医院内分泌科,山东济南250013 [2]中国中医科学院中医临床基础医学研究所,北京100700 [3]山东中医药大学附属医院消化科,山东济南250013

出　　处：《中国医学创新》2025年第8期139-146,共8页Medical Innovation of China

基　　金：国家自然科学基金项目(81974562);山东省泰山学者工程专项项目(tsqn202211354);山东省自然科学基金项目(ZR2024MH245);钱秋海全国名老中医药专家传承工作室(国中医药人教函[2022]75号)。

摘　　要：目的:系统评价推拿疗法在肥胖合并2型糖尿病患者中的临床疗效及安全性,为临床治疗提供循证医学依据。方法:检索PubMed、Web of Science、Embase、Cochrane Library、中国知网、万方、维普数据库,收集截至2025年2月6日发表的关于推拿治疗肥胖合并2型糖尿病的随机对照试验(RCT)。按照PICOS原则筛选符合标准的研究,采用RevMan 5.4软件进行Meta分析。结果:共纳入8项RCT研究,涉及531例患者(治疗组266例,对照组265例)。Meta分析结果显示,与单纯基础治疗相比,推拿联合基础治疗在降低空腹血糖(FPG)[MD=-0.71,95%CI(-0.93,-0.49),P<0.001]、餐后2 h血糖(2 h PG)[MD=-1.05,95%CI(-1.30,-0.80),P<0.001]及胰岛素抵抗指数(HOMA-IR)[MD=-1.81,95%CI(-2.20,-1.42),P<0.001]方面均具有显著优势。此外,推拿联合基础治疗可有效降低体重指数(BMI)[MD=-0.67,95%CI(-1.09,-0.24),P=0.002],减少腰围[MD=-2.35,95%CI(-3.38,-1.33),P<0.001],并改善总胆固醇(TC)[MD=-0.80,95%CI(-1.06,-0.55),P<0.001]和甘油三酯(TG)[MD=-0.40,95%CI(-0.48,-0.32),P<0.001]。推拿治疗未显著增加不良反应发生率,与对照组差异无统计学意义(P>0.05)。结论:推拿联合基础治疗可有效改善肥胖合并2型糖尿病患者的血糖、血脂及体重指标,具有良好的临床疗效和安全性。Objective:To systematically evaluate the clinical efficacy and safety of Tuina therapy in patients with obesity and type 2 diabetes mellitus,providing evidence-based support for clinical treatment.Method:A comprehensive search was conducted in PubMed,Web of Science,Embase,Cochrane Library,CNKI,Wanfang,and VIP databases for randomized controlled trial(RCT)on Tuina therapy for obesity with type 2 diabetes mellitus,published up to February 6,2025.Studies meeting the PICOS criteria were included,and a meta-analysis was performed using RevMan 5.4 software.Result:A total of 8 RCTs involving 531 patients(266 in the treatment group and 265 in the control group)were included.Meta-analysis results showed that compared with conventional treatment alone,Tuina combined with conventional treatment significantly improved fasting plasma glucose(FPG)[MD=-0.71,95%CI(-0.93,-0.49),P<0.001],2-hour postprandial glucose(2 h PG)[MD=-1.05,95%CI(-1.30,-0.80),P<0.001],and homeostatic model assessment of insulin resistance(HOMA-IR)[MD=-1.81,95%CI(-2.20,-1.42),P<0.001].Additionally,Tuina combined with conventional treatment significantly reduced body mass index(BMI)[MD=-0.67,95%CI(-1.09,-0.24),P=0.002],waist circumference[MD=-2.35,95%CI(-3.38,-1.33),P<0.001],total cholesterol(TC)[MD=-0.80,95%CI(-1.06,-0.55),P<0.001],and triglycerides(TG)[MD=-0.40,95%CI(-0.48,-0.32),P<0.001].No significant difference was observed in the incidence of adverse events between the Tuina and control group(P>0.05).Conclusion:Tuina therapy combined with conventional treatment effectively Medical Innovation of China Vol.22,No.8 March,2025 improve blood glucose,lipid metabolism,and body weight parameters in patients with obesity and type 2 diabetes mellitus,demonstrating promising clinical efficacy and safety.

关 键 词：推拿 肥胖合并2型糖尿病 随机对照试验 META分析 

分 类 号：R58[医药卫生—内分泌]