2型糖尿病中医特色健康教育干预效果的Meta分析

Meta-analysis of the Intervention Effect on Traditional Chinese Medicine Feature Health Education to Type 2 Diabetic Patients

目的运用Meta分析方法比较中医特色健康教育与传统教育对糖尿病患者生化指标等的影响。方法检索Pub Med、Medline、CBM disc、Cochrane图书馆、中国知网、维普、万方和中国优秀博硕士学位论文全文数据库,追踪查阅临床试验报告论文或综述的参考文献、学术会议论文集(检索中国重要会议论文全文数据库)等,年限在2000年1月—2017年5月。全面收集中医特色健康教育的临床随机对照研究,对纳入的文献进行质量评价与数据提取,采用Revman5.3软件对数据进行Meta分析。结果共纳入15篇临床随机对照研究,共1 510例患者,其中干预组759例,对照组751例。干预组患者空腹血糖(SMD=-0.74,P<0.01)、餐后2h血糖(SMD=-0.74,P<0.01)、糖化血红蛋白(SMD=-0.81,P<0.01)、总胆固醇(SMD=-0.33,P<0.01)、中医证候分级积分(SMD=-1.97,P<0.01)降低,空腹C肽(SMD=0.55,P<0.01)、有效率(SMD=3.90,P<0.01)、自我照顾行为评分(SMD=1.43,P<0.01)升高,优于对照组。敏感性分析显示结果稳定可靠。结论在药物治疗的基础上,结合使用中医特色健康教育,比传统教育方法在改善患者生化指标,促进血糖血脂达标,降低患者中医证候分级积分,升高空腹C肽,提高治疗有效率和自我照顾行为评分等方面均有一定疗效,但研究方法学的质量有待进一步提高,需要更多高质量的随机对照试验证实。

Objective To compare indicators such as the biochemical indicators between the health education of Traditional Chinese Medicine（TCM） and the traditional health education in patients with diabetic by meta-analysis. Methods By retrieving Pub Med, Medline, CBM disc, the Cochrane library, CNKI, CPVIP, Wanfang Data, and Chinese Selected Doctoral Dissertations and Master＇s Theses Full-Text Databases, following up the literature of the clinical trial report, review, and proceedings of the academic conference（retrieving the full text database of China＇s important conference papers）, etc., fixed number of year of the retrieval from January 2000 to May 2017. Comprehensively collecting clinical randomized controlled study for diabetic, the data meta-analyzed through Revman 5.3 software, to evaluate the quality and extracting dates of the included literatures. Results A total of 15 papers on clinical randomized controlled study and 1,510 patients were included in the meta analysis, included 759 intervention group cases, and 751 control group cases. To intervention group, fasting plasma glucose（SMD=﹣0.74,P0.01）, 2h postprandial blood glucose（SMD=﹣0.74, P0.01）, glycosylated hemoglobin（SMD=﹣0.81, P0.01）, total cholesterol（SMD=﹣0.33, P0.01） and TCM syndrome classification integral（SMD=﹣1.97, P0.01） had decreased; fasting c-peptide（SMD=0.55, P0.01）, efficient（SMD=3.90, P0.01）, self-care behavior score（SMD=1.43, P0.01） had increased. Sensitivity analysis showed that the results were stable and reliable. Conclusion On the basis of drug therapy, the health education of TCM could reduce the blood sugar and blood fat, and TCM syndrome classification integral, and elevated fasting c-peptide, improved the treatment efficiency and self-care behavior score, but the methodological quality remained to be further improved, which needed more high-quality randomized, placebo-controlled literatures confirmed.