摘要
目的系统评价中医传统功法治疗糖尿病周围神经病变的临床疗效。方法计算机检索英文数据库PubMed、Web of Science、the Cochrane Library、Embase,中文数据库中国知网(CNKI)、万方知识服务平台(WAN-FANG DATA)、维普数据库(VIP)、中国生物医学文献服务系统(CBM)。搜集中医传统功法治疗糖尿病周围神经病变的随机对照研究(RCT),检索时间限定为建库至2022年12月30日。文献应用NoteExpress软件进行筛选管理,由2名研究员按照纳入排除标准独立对文献信息进行提取;应用Cochrane偏倚风险评估工具对纳入文献进行评价;采用Review Manager 5.4软件进行Meta分析。结果共纳入13个研究,共计930名患者,对照组464例,治疗组466例。结果提示中医传统功法治疗糖尿病周围神经病变患者对于提高临床有效率(RR=1.48,95%CI=1.29~1.71,P<0.05),改善餐后2 h血糖(MD=-0.63,95%CI=-0.96~-0.30,P<0.05)、糖化血红蛋白(MD=-0.32,95%CI=-0.54~-0.10,P<0.05)、TCSS评分(MD=-1.88,95%CI=-2.74~-1.02,P<0.05)、神经传导速度(MD=2.31,95%CI=-1.20~3.42,P<0.05)、中医证候积分(MD=-4.83,95%CI=-7.00~-2.65,P<0.05)等方面均由于常规治疗组,且安全性较高(RR=2.63,95%CI=0.65~10.59,P>0.05)。结论中医传统功法联合常规治疗可明显提高糖尿病周围神经病变患者临床效果,且安全性较高。但由于纳入研究样本量较低,所以存在一定的发表偏倚,需要更要高质量的临床RCT对研究结论进行进一步验证。
Objective To evaluate the clinical effect of traditional Chinese medicine(TCM)on diabetic peripheral neuropathy.Method PubMed,Web of Science,the Cochrane Library,Embase,China National Knowledge Network(CNKI),Wanfang Data,China Science and Technology Journal Database(VIP),and China Biology Medicine disc(CBM)were searched to collect the randomized controlled trials(RCTs)of TCM treatment of diabetic peripheral neuropathy.The retrieval time was from the inception of the databases to December 30,2022.The literature was screened and managed by NoteExpress,and the literature information was extracted independently by two researchers according to the inclusion and exclusion criteria.Cochrane risk of bias tool was used to evaluate the included literature.Meta-analysis was performed u-sing Review Manager 5.4.Results A total of 13 RCTs were included in this study,involving 930 patients,464 in the con-trol group and 466 in the treatment group.The results suggested that TCM therapies increased the clinical effective rate(RR=1.48,95%CI=1.29~1.71,P<0.05),and improved the 2-h postprandial blood glucose(MD=-0.63,95%CI=-0.96~-0.30,P<0.05),glycosylated hemoglobin(MD=-0.32,95%CI=-0.54~-0.10,P<0.05),Toronto clinical scoring system(TCSS)score(MD=-1.88,95%CI=-2.74~-1.02,P<0.05),nerve conduction velocity(MD=2.31,95%CI=-1.20~3.42,P<0.05),and TCM syndrome score(MD=-4.83,95%CI=-7.00~-2.65,P<0.05)compared with the conventional treatment group,and the safety was higher(RR=2.63,95%CI=0.65~10.59,P>0.05).Conclusion TCM combined with conventional treatment can significantly enhance the clinical effect of patients with diabetic peripheral neuropathy,with high safety.However,due to the low sample size of the included studies,there is a certain publication bias,and more high-quality clinical RCTs are needed to further verify the research conclusion.
作者
孙璇
王东军
田之魁
原茵
曾仙月
张乃金
刘颖
岳树娇
王泓午
SUN Xuan;WANG Dong-jun;TIAN Zhi-kui;YUAN Yin;ZENG Xian-yue;ZHANG Nai-jin;LIU Ying;YUEShu-jiao;WANG Hong-wu(Graduate School,Tianjin University of Traditional Chinese Medicine,Tianjin 301600;Traditional Chinese Medical College,North China University of Science and Technology,Tangshan Hebei 063210)
出处
《世界中西医结合杂志》
2023年第11期2164-2171,2177,共9页
World Journal of Integrated Traditional and Western Medicine
基金
国家重点研发计划(2017YFC1703305)
国家重点基础研究发展计划(973计划)(2011 CB505406)
河北省中医药管理局2022年度中医药类科研计划(2022554)。
关键词
中医传统功法
糖尿病周围神经病变
随机对照试验
系统评价
Traditional Chinese medicine
Diabetic peripheral neuropathy
Randomized controlled trials
Systemat-ic evaluation
