针刺辅助治疗糖尿病足疗效的Meta分析

Acupuncture as adjuvant treatment for diabetic foot： a systematic review and meta-analysis

目的探讨针灸辅助治疗糖尿病足（DF）的临床疗效及其安全性。方法计算机检索MEDLINE、Embase、CENTRAL、SinoMed、VIP、CNKI和WANFANG数据库，并手工检索相关会议论文集及查阅检获所有文献的参考文献，全面收集针灸辅助治疗DF的临床随机或半随机对照试验，由2名评价者独立进行数据提取和质量评价后，采用RevMan5．1软件进行Meta分析。结果纳入7项研究共626例。7项研究均采用临床疗效为评价指标，Meta分析结果显示针灸辅助治疗DF能显著提高总有效率[RR=1．29，95％CI（1．20，1．38）；P〈0．01]和临床治愈率[RR=1．92，95％CI（1．60，2．30）；P〈0．01]。未见不良反应。结论针灸辅助治疗DF安全有效；因原始研究的质量均较低，建议审慎选择使用；并严格按照CONSORT标准设计高质量、大样本的研究进一步论证。

Objective To evaluate the efficacy and safety of acupuncture as adjuvant treatment in the management of diabetic foot （DF）. Methods We searched MEDLINE, Embase, CENTRAL, SinoMed, VIP, CNKI and WANFANG database. We also searched the bibliographies of retrieved articles and correlated proceed- ings and collected the literatures of DF of clinically randomized or quasi-randomized control trials of acupuncture as adjuvant treatment. After the data was extracted independently by 2 reviewers, we performed meta-analysis by using RevMan 5.1 software. Results Seven studies included 626 patients who met the inclusion criteria, and all employed clinical effects as evaluation indicator. Meta-analysis showed that acupuncture as adjuvant treatment could obviously improve the total effectiveness rate （ RR = 1.29, 95% CI： 1.20, 1.38, P 〈 0. 00001 ） and the recovery rate （ RR = 1.92, 95% CI： 1.60, 2.30, P 〈0. 00001 ）. No adverse reactions occured. Conclusions The limited current evidence shows that acupuncture as adjuvant treatment is safe and effective in the treatment of DF. Due to the poor quality of original studies, a prudent choice is suggested. Further studies with high quality and large samples according to CONSORT are also warrant.