摘要
目的:系统评价血府逐瘀汤治疗糖尿病周围神经病变的有效性。方法:通过计算机检索电子数据库PubMed、EMBASE、Cochrane Library、Web of Science、中国知网、万方、中国生物医学文献数据库和维普中文科技期刊。筛选自建库起至2019年10月所有关于血府逐瘀汤治疗糖尿病周围神经病变的随机对照试验,同时手工检索相关文献。采用Cochrane随机对照试验偏倚风险评估工具对文献进行偏倚风险评估。采用RevMan 5.3软件进行Meta分析。结果:共纳入文献33篇,包括2 673例患者。Meta分析结果显示,血府逐瘀汤可有效治疗糖尿病周围神经病变(RR=1.24,95%CI [1.18,1.29],P<0.000 01);可显著提高腓总神经运动神经传导速度(SMD=1.86,95%CI [0.96,2.76],P<0.000 1);可明显提高腓总神经感觉神经传导速度(SMD=1.85,95%CI [1.24,2.46],P<0.000 01);可有效降低患者血糖(SMD=-1.64,95%CI[-2.01,-1.27],P<0.000 01)。结论:血府逐瘀汤可显著改善糖尿病周围神经病变的症状。但由于方法学缺陷、发表偏倚等因素,可能会夸大干预效应。未来临床试验研究中,需进行临床试验注册,需注重提升方法学质量,确保临床研究结果的准确性和可靠性。另外,可将血府逐瘀汤的安全性研究作为研究方向,以便血府逐瘀汤的临床推广应用。
Objective:To systematically evaluate the effectiveness of Xuefu Zhuyu Decoction in the treatment of diabetic peripheral neuropathy.Methods:The electronic databases PubMed,EMBASE,Cochrane Library,Web of Science,China National Knowledge Infrastructure,Wanfang,China Biomedical Literature Database and Weipu Science and Technology Periodicals were searched.All randomized controlled trials on the treatment of diabetic peripheral neuropathy with Xuefu Zhuyu Decoction since the establishment of the database until October 2019 were screened,and relevant literatures were manually searched.The Cochrane bias risk assessment tool of randomized controlled trial was used to evaluate the bias risk in the literature.Meta analysis was performed using RevMan 5.3 software.Results:A total of 33 articles were included,including 2 673 patients.The results of Meta analysis show that Xuefu Zhuyu Decoction can effectively treat diabetic peripheral neuropathy(RR=1.24,95% CI [1.18,1.29],P<0.000 01);It can significantly increase the motor nerve conduction velocity of the common peroneal nerve(SMD=1.86,95%CI[0.96,2.76],P<0.000 1);It can significantly improve the sensory nerve conduction velocity of the common peroneal nerve(SMD=1.85,95% CI [1.24,2.46],P<0.000 01);It can effectively reduce patients’blood glucose(SMD=-1.64,95%CI[-2.01,-1.27],P<0.000 01).Conclusion:Xuefu Zhuyu Decoction can significantly improve the symptoms of diabetic peripheral neuropathy.However,the effect of intervention may be exaggerated because of methodological flaws,publication bias and other factors.In future clinical trial research,clinical trial registration is required,and methodological quality needs to be improved to ensure the accuracy and reliability of clinical research results.In addition,the safety research of Xuefu Zhuyu Decoction can be taken as the research direction for the clinical popularization and application of Xuefu Zhuyu Decoction.
作者
张俊立
董玮玮
杨梅
胡恒昶
Zhang Junli;Dong Weiwei;Yang Mei;Hu Hengchang(Department of Traditional Chinese Medicine,Nanchong Central Hospital,Nanchong 637000,China;Acupuncture School of Hospital of Chengdu University of Traditional Chinese Medicine,Longquan Campus,Chengdu 610103,China)
出处
《亚太传统医药》
2020年第3期164-171,共8页
Asia-Pacific Traditional Medicine
关键词
血府逐瘀汤
糖尿病周围神经病变
随机对照试验
系统评价与Meta分析
Xuefu Zhuyu Decoction
Diabetic Peripheral Neuropathy
Randomized Controlled Trial
Systematic Review and Meta-analysis
作者简介
张俊立(1991-),男,四川省南充市中心医院中医科住院医师,研究方向为内科常见病多发病的中西医结合临床。E-mail:1040026595@qq.com;通讯作者:胡恒昶(1992-),男,成都中医药大学附属医院针灸学校龙泉校区教师,研究方向为中医药防治内分泌代谢性疾病的临床及实验。E-mail:huhc1213@163.com。
