摘要
目的通过meta分析评价中西医结合治疗下肢动脉硬化闭塞症的临床疗效。方法检索中国知网、维普、Embase、PubMed、Cochrane Library等中英文数据库,选取中西医结合治疗下肢动脉硬化闭塞症(ASO)的临床随机对照试验(RCT),检索时间为2015年1月至2021年5月。采用RevMan 5.4软件对结局指标有效率、踝肱指数(ABI)、治疗后足背动脉血管内径、流速峰值、血流量、全血黏度、血浆黏度、血脂指标甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)进行meta分析。结果共纳入符合标准的18个RCT,其中试验组949例,对照组946例。荟萃分析结果显示:治疗后,试验组有效率[MD=3.74,95%CI=(2.73,5.13),P<0.01]、足背动脉血管内径[OR=0.20,95%CI=(0.08,0.32),P<0.01]、足背动脉流速峰值[MD=-0.13,95%CI=(-0.16,-0.10),P<0.01]、足背动脉血流量[MD=4.74,95%CI=(3.95,5.53),P<0.01]、踝肱指数[MD=0.13,95%CI=(0.09,0.17),P<0.01]均高于对照组,全血黏度[MD=-1.10,95%CI=(-1.46,-0.74),P<0.01]、血浆黏度[MD=-0.28,95%CI=(-0.36,-0.20),P<0.01]、甘油三酯[MD=-0.45,95%CI=(-0.87,-0.03),P=0.03]、总胆固醇[MD=-1.10,95%CI=(-2.14,-0.07),P=0.04]、低密度脂蛋白[MD=-0.76,95%CI=(-1.09,-0.43),P<0.01]均低于对照组,差异均有统计学意义(P<0.05)。结论中西医结合治疗下肢动脉硬化闭塞症患者疗效显著,但因所纳入的临床对照研究质量偏低,其临床疗效仍需质量较高的临床随机、双盲、平行对照试验加以证明,需谨慎使用该证据,但临床实际应用可以加以借鉴。
Objective To evaluate the clinical efficacy of integrated traditional Chinese and western medicine in the treatment of lower extremity arteriosclerosis obliterans by meta-analysis.Methods CNKI,VIP,Embase,PubMed,Cochrane Library and other Chinese and English databases were searched to select the clinical randomized controlled trial(RCT)of integrated traditional Chinese and western medicine in the treatment of lower extremity arteriosclerosis obliterans(ASO)from January 2015 to May 2021.RevMan 5.4 software was used to perform a meta-analysis of the outcome indicators such as effective rate,ankle-brachial index(ABI),vascular diameter,peak velocity,blood flow,whole blood viscosity,plasma viscosity,and blood lipid indicators such as triglyceride(TG),total cholesterol(TC),low-density lipoprotein(LDL-C)after treatment of dorsal foot artery.Results A total of 18 RCTs were included,with 949 cases in the experimental group and 946 cases in the control group.Results of the meta-analysis showed that:After treatment,the effective rate(MD=3.74,95%CI=[2.73,5.13],P<0.01),the diameter of dorsalis pedis artery(OR=0.20,95%CI=[0.08,0.32],P<0.01),the peak flow velocity of dorsalis pedis artery(MD=-0.13,95%CI=[-0.16,-0.10],P<0.01),dorsalis pedis artery blood flow(MD=4.74,95%CI=[3.95,5.53],P<0.01),ankle brachial index(MD=0.13,95%CI=[0.09,0.17],P<0.01)in the experimental group were higher than those in the control group.The whole blood viscosity(MD=-1.10,95%CI=[-1.46,-0.74],P<0.01),plasma viscosity(MD=-0.28,95%CI=[-0.36,-0.20],P<0.01),triglycerides(MD=-0.45,95%CI=[-0.87,-0.03],P=0.03),total cholesterol(MD=-1.10,95%CI=[-2.14,-0.07],P=0.04),low density lipoprotein(MD=-0.76,95%CI=[-1.09,-0.43],P<0.01)in the experimental group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion The efficacy of integrated traditional Chinese and Western medicine in the treatment of patients with lower extremity arteriosclerosis obliterans is significant,but due to the low quality of the included clinical controlled studies,its clinical efficacy still needs to be proved by high quality clinical randomized,double-blind,parallel controlled trials.This evidence needs to be used with caution,but the clinical practice can be used for reference.
作者
张棋鑫
彭栋
陈旭
段磊
阿拉法特·艾尔肯
沙尔娜
陈世楷
ZHANG Qixin;PENG Dong;CHEN Xu;DUAN Lei;Arafat·ELKEN;SHA Erna;CHEN Shikai(Interventional Diagnosis and Treatment Center,the Second Affiliated Hospital of Xinjiang Medical University,Xinjiang Uygur Autonomous Region,Urumqi 830092,China;The Fourth Clinical Medical College,Xinjiang Medical University,Xinjiang Uygur Autonomous Region,Urumqi 830092,China;The First Clinical College,Shaanxi University of Chinese Medicine,Shaanxi Province,Xi'an 712046,China)
出处
《中国当代医药》
CAS
2023年第17期9-15,共7页
China Modern Medicine
基金
新疆维吾尔自治区自然科学基金面上项目(2020 D01C185)。
关键词
下肢动脉硬化闭塞症
中西医结合
介入治疗
META分析
Lower extremity arteriosclerosis obliterans
Integrated traditional Chinese and western medicine
Interventional therapy
Meta analysis
作者简介
通讯作者:彭栋。
