针灸治疗2型糖尿病周围神经病变对腓神经神经传导速度影响的Meta分析

Influence of Acupuncture-moxibustion on the Peroneal Nerve Conduction Velocity in Type 2 Diabetic Peripheral Neuropathy:A Meta-analysis

目的系统评价针灸治疗2型糖尿病周围神经病变(DPN)对腓神经神经传导速度的影响,为针灸治疗DPN提供临床参考。方法通过检索中国生物力学文献数据库(CBM)、中国期刊全文数据库(CNKI)、维普期刊数据库(VIP)、万方数据库、Pub Med、Springer、Medline数据库,收集2000年1月至2014年1月关于针灸治疗2型DPN的随机对照试验(RCT),提取腓神经传导速度相关资料并进行方法学质量评价,采用Rev Man 5.1软件进行Meta分析。结果共纳入10个随机对照试验,合计685例患者,其中治疗组355例,对照组330例。Meta分析结果显示,针灸治疗2型DPN在提高腓神经运动神经传导速度(MNCV)和感觉神经传导速度(SNCV)方面可能优于对照组,差异均有统计学意义[MD=3.55,95%CI(0.79,6.31);MD=4.10,95%CI(0.22,7.99)]。结论针灸治疗2型DPN可以改善腓神经传导速度,值得临床应用。但由于本系统评价纳入研究较少,样本量小,且质量不高,存在偏倚的高度可能性,因此上述结论尚需要高质量、大样本、多中心的随机对照试验加以证实。

Objective To systematically evaluate the influence of acupuncture-moxibustion on the peroneal nerve conduction velocity in type 2 diabetic peripheral neuropathy（DPN）, and to provide clinical references for acupuncture-moxibustion treatment for DPN. Method By searching the CBM, CNKI, VIP, Wanfang, Pubmed, Springer and Medline databases, randomized controlled trials（RCT） of acupuncture-moxibustion for the type 2 DPN published from January 2000 to January 2014 were retrieved and the relevant data of the peroneal nerve conduction velocity were collected for methodological evaluation. Rev Man 5.1 software was adopted to conduct the meta-analysis. Result Totally 10 RCTs were recruited with 685 cases involved, including 355 cases in the treatment group and 330 cases in the control group. The meta-analysis results indicated that acupuncture-moxibustion can produce a better effect in improving the motor nerve conduction velocity（MNCV） and sensory nerve conduction velocity（SNCV） of peroneal nerve in type 2 DPN than the treatments used in the control group, and the differences were statistically significant between the two groups [MD=3.55, 95%CI（0.79, 6.31）; MD=4.10, 95%CI（0.22, 7.99）]. Conclusion Acupuncture-moxibustion can improve the peroneal nerve conduction velocity in type 2 DPN, and thus is worth application in clinic. Due to the limitation of the included studies, such as small sample size and low quality of the articles and high probability of bias, RCTs of large sample size and high quality are required to confirm the above conclusions.