黄芪桂枝五物汤治疗糖尿病周围神经病变的Meta分析

Meta-analysis of randomized comparative study on Huangqi Guizhi Wuwu Tang in the treatment of diabetic peripheral neuropathy

目的系统评价黄芪桂枝五物汤治疗糖尿病周围神经病变的有效性及安全性。方法通过计算机检索Medline、EMBase、Ovid、Cochrane数据库和中国生物医学文献数据库、维普中文科技期刊数据库、中国知网和万方数据库,筛选2013年10月之前报道的黄芪桂枝五物汤治疗糖尿病周围神经病变的随机对照试验;同时手工检索杂志刊登的相关文献。文献入选标准:在常规治疗的基础上,试验组采用黄芪桂枝五物汤治疗,对照组采用安慰剂或空白对照。采用总有效率作为结局指标。对文献进行质量评价,纳入合格文献,采用RevMan 5.0软件进行Meta分析。结果共纳入文献22篇,包括1 450例患者。Meta分析结果显示:黄芪桂枝五物汤治疗组可有效治疗糖尿病周围神经病变[OR=4.73,95%CI为(3.62,6.17)];总有效率优于维生素B族药物,且比较差异有统计学意义[OR=4.33,95%CI为(2.13,8.83)];黄芪桂枝五物汤治疗总有效率优于甲钴胺,且比较差异有统计学意义[OR=3.76,95%CI为(2.49,5.67)]。结论黄芪桂枝五物汤可安全有效的用于治疗糖尿病周围神经病变。

Objective To evaluate the clinical efficacy of Huangqi Guizhi Wuwu Tang （HQGZWWT） on treating diabetic peripheral neuropathy and its safety. Methods Random controlled trials of HQGZWWT for diabetic peripheral neuropathy （DPN） reported before October 2013 were retrieved through Medline, Em- base, Ovid database, the Cochrane central register of controlled, CBM disc, VIP, CNKI, Wanfang database and relevant literatures. Based on conventional treatment, experimental group received HQGZWWT treat- ment, control group received placebo or blank control. Then Meta-analysis was conducted with RevMan 5.0 software. Results A total of 22 papers involving 1450 patients were selected. The results of Meta-analysis showed that HQGZWWT was effective in treating DPN, OR = 4.73,95% CI（3.62,6. 17 ）; In addition, HQGZWWT was significantly superior to vitamin B in total effective rate, OR = 4.33,95% CI （2. 13, 8.83）; also HQGZWWT was significantly superior to mecobalamin in total effective rate. Conclusions HQGZWWT may have better effectiveness and more safety for DPN.