中医药治疗糖尿病并发抑郁症随机对照临床试验的Meta分析

Meta-Analysis of Randomized Controlled Trials of Traditional Chinese Medicine in Treatment of Diabetes Mellitus Complicated with Depression

目的:研究分析中医药治疗糖尿病并发抑郁症的临床效果及各相关指标的变化。方法:通过检索2005—2016年中国期刊全文数据库(CNKI),中国生物医学数据库(CBM),万方数据库,维普数据库(VIP)中国内公开发表的中医药治疗糖尿病并发抑郁症的随机对照试验(RCT),运用Rev Man 5.3软件对符合纳入标准的文献进行Meta分析,比较分析中医药疗法与单纯西医疗法治疗糖尿病并发抑郁症的临床效果,以及治疗后患者空腹血糖,汉密尔顿抑郁量表(HAMD)评分的变化。结果:经过逐步筛选,最终纳入12个随机对照试验,共836例糖尿病并发抑郁症患者,Meta分析结果显示与对照组相比,中医药治疗糖尿病并发抑郁症的总体疗效较好,差异具有统计学意义(P<0.05),患者治疗后空腹血糖,HAMD评分均降低,差异具有统计学意义(P<0.05)。结论:中医药治疗糖尿病并发抑郁症的疗效优于单纯西医治疗,在降低血糖、HAMD评分方面具有较好的疗效,因纳入文献样本有限以及文献质量不高,尚需大样本以及多中心随机对照双盲试验的高质量研究来加以验证。

Objective：To investigate the clinical effect and the changes of related indexes in the treatment of diabetes mellitus complicated with depression by TCM.Methods：By searching published random control trail（RCT） of traditional Chinese medicine in the treatment of diabetes complicated with depression in China journal full text database（CNKI）,Chinese biomedical database（CBM）,Wanfang database and VIP database（VIP） from 2005 to 2016,using Rev man 5.3 software,the literature which met the inclusion criteria was carried out a Meta-analysis.Compare and analyze the clinical effect of the therapy of traditional Chinese medicine and Western medicine therapy alone in the treatment of diabetic patients suffering from depression,and after treatment patients’ fasting blood glucose（FBG）,Hamilton Depression table（HAMD） score changes.Results：After stepwise selection,ultimately twelve randomized controlled trials were enrolled with a total of 836 cases of diabetes complicated with depression patients.The Meta-analysis results showed compared with the control group,the overall efficacy of traditional Chinese medicine in the treatment of diabetes mellitus complicated with depression was good and the difference was statistically significant（P〈0.05）.After treatment,patients’ fasting blood glucose（FBG） and the scores of HAMD decreased with a statistically significant difference（P〈0.05）.Conclusion：TCM drugs in the treatment of diabetes mellitus complicated with depression has better curative effect than pure western medicine treatment in lowering blood glucose and HAMD scores.Because the sample documents and literature quality is not high,it still needs a large sample and multi center,double-blind,randomized controlled clinical trials of high quality research to be verified.