补阳还五汤加减联合综合疗法治疗糖尿病视网膜病变的疗效及安全性Meta分析  

Meta-analysis of the efficacy and safety of Buyang Huanwu Decoction combined with comprehensive therapy in the treatment of diabetic retinopathy

作　　者：唐云华 柯殷雨 张富文 Tang Yunhua;Ke yinyu;Zhangfuwen(Eye School of Chengdu University of TCM,Chengdu,Sichuan,610075;Key Laboratory of Sichuan Province Ophthalmopathy Prevention&Cure and Visual Function Protection with TCM Laboratory,Chengdu,Sichuan,610075;Image Technology and Chronic Vascular Disease Prevention&Control and Collaborative Innovation Center,Chengdu,Sichuan,610075;Ziyang Hospital of TCM,ZiYang,Sichuan,641300;Ineye Hospital of Chengdu University of TCM,Chengdu,Sichuan,610084)

机构地区：[1]成都中医药大学眼科学院,四川成都610075 [2]中医药眼病防治与视功能保护四川省重点实验室,四川成都610075 [3]视网膜图像技术与慢性血管性疾病防治协同创新中心,四川成都610075 [4]资阳市中医医院,四川资阳641300 [5]成都中医药大学附属银海眼科医院,四川成都610084

出　　处：《中医眼耳鼻喉杂志》2025年第2期95-100,共6页Journal of Chinese Ophthalmology and Otorhinolaryngology

基　　金：四川省自然科学基金资助(No.2023NSFSC0690)。

摘　　要：目的系统评价补阳还五汤加减联合综合疗法治疗糖尿病视网膜病变(diabetic retinopathy,DR)患者的治疗效果及安全性。方法检索数据库筛选出采用补阳还五汤加减联合综合疗法治疗DR的随机对照试验(Randomized Controlled Trial,RCT)研究。由2名评价员独立筛选文献、提取资料,并对所纳人文献的质量和偏倚风险进行评估,随后使用Revman5.3软件进行Meta分析。结果分析纳人了16篇文献,涉及1560例患者。Meta分析结果显示,与对照组相比,试验组在提高总有效率[RR=1.28,95%CI(1.23,1.34),P<0.00001]。视力有效率[RR=1.14,95%CI(1.09,1.19),P<0.00001]以及改善荧光造影检查(FFA)[RR=1.26,95%CI(1.18,1.34)P<0.00001]指标上显著优于对照组,且副作用发生率低。但在中医证候改善、糖化血红蛋白(Glycosylated hemoglob in levels A1c,HbA1c)、空腹血糖、餐后2小时血糖方面与对照组无统计学上的显著差异。结论现有研究数据表明,补阳还五汤加减联合综合疗法治疗DR患者可有效提升临床疗效及视力,对眼底病变有改善作用,但对改善中医证候和调节血糖无显著效果。然而,仍需通过大型样本、多中心、高质量的RCT研究来验证这一结论。Objective Systematically evaluate the therapeutic effect and safety of modified Buyang Huanwu Decoction combined with comprehensive therapy in the treatment of patients with diabetic retinopathy(DR).Methods Search the database to filter out Randomized Controlled Trials(RCT)using modified and subtracted Buyang Huanwu Decoction combined with comprehensive therapy to treat DR.Two reviewers independently screened the literature,extracted data,and assessed the quality and risk of bias of the included literature,and then used Revman5.3 software to conduct a Meta-analysis.Results The analysis included 16 literatures,involving 1560 patients.Meta analysis results showed that compared with the control group,the experimental group improved the total effective rate[RR=1.28,95%CI(1.23,1.34),P<0.00001]and visual acuity effective rate[RR=1.14,95%CI(1.09,1.19),P<0.00001]and improved fluorescence imaging(FFA)[RR=1.26,95%CI(1.18,1.34),P<0.00001] were significantly better than the control group,and the incidence of side effects Low.However,there was no statistically significant difference from the control group in terms of improvement of TCM syndrome,Glycosylated hemoglobin levels Alc(HbAlc),fasting blood sugar,and 2-hour post-prandial blood sugar.Conclusion Existing research data shows that tonifying yang also restores the five functions of the body.The combination of decoction and comprehensive therapy in the treatment of DR patients can effectively improve clinical efficacy and visual acuity,and improve fundus lesions,but has no significant effect on improving TCM syndromes and regulating blood sugar.However,large-scale samples,multi-center,and high-quality studies are still needed.An RCT study was conducted to verify this conclusion.

关 键 词：补阳还五汤加减 综合疗法 糖尿病视网膜病变 随机对照试验 META分析 

分 类 号：R587.2[医药卫生—内分泌]