中医药治疗原发性开角型青光眼的meta分析

Traditional Chinese medicine on primary open-angle glaucoma: a meta analysis

目的旨在通过系统检索、文献筛选,完成meta分析,总结中医药治疗开角型青光眼有效方案及药物。方法全面检索中文文献数据库主要包括CNKI、维普、CBM、万方全文数据库、中医古籍数据库,英文文献数据库主要来源于PubMed、Cochrane Library《循证医学数据库》,共7个数据库。检索时间均为建库至2016年5月30日。依据纳入及排除标准筛选文献,使用Review Manager5.3软件进行meta分析。结果 (1)共有56篇文献符合要求,治疗平均疗程13.82周,将有效结局指标进行汇总,制定出《中药治疗开角型青光眼有效结局指标汇总表》。(2)在检索数量上,以"活血利水的中药、补肾活血明目的中药及活血中成药"治疗开角型青光眼相关报道的文献数量最多。(3)中药治疗开角型青光眼常用药物有活血利水的汤药、补肾活血明目的中药、补肾明目的中药、活血中成药、益气活血化瘀中药、疏肝养血中药,其中以活血利水的中药、补肾活血明目的中药及活血中成药相关的meta分析较多,效果较好。(4)中医药在控制眼压和视力方面,作用有限。(5)中医药治疗开角型青光眼较为安全。结论中医药在改善青光眼患者视野方面,疗效确切,值得推广。

OBJECTIVE To summarize the effective plan and drug for open-angle glaucoma with Chinese medicine by meta-analysis with systematic retrieval and literature screening.METHODS The comprehensive search of Chinese literature databases mainly included CNKI,VIP,CBM,Wanfang full-text database,and ancient Chinese medicine database.The English literature database mainly involved PubMed and Cochrane Library's Evidence-based Medicine Database.A total of7databases were used in this study.The date of all studies was from the database establishment to May30th,2016.According to the screening literature of the inclusion and exclusion criteria,the meta analysis was performed using the Review Manager5.3software.RESULTS(1)A total of56studies met the requirements,and the average treatment course lasted13.82weeks.The effective outcome indicators were summarized and the"Summary Table of Effective Outcome Indicators for the Treatment of Open Angle Glaucoma by Chinese Medicine"was formulated.(2)Retrieval result showed there were largest number of reported studies employing herbs with circulation-promoting and water-draining effects,kidney-invigorating,circulation-activating and vision-improving effets,as well as blood-activating Chinese patent medicine to treat open angle glaucoma.(3)The common Traditional Chinese medicine(TCM)used in treatment of primary open-angle glaucoma drugs were blood-activating and water-draining formulae,kidney-invigorating,circulation-activating and vision-improving herbs,kidney-invigorating,circulation-activating herbs,blood-activating Chinese patent medicine,qi-tonifying,blood-activating and stasis-removing herbs,liver-smoothing,blood-tonifying herbs.Specifically,blood-activating and water-draining formulae,kidney-invigorating,circulation-activating and vision-improving herbs and blood-activating Chinese patent medicine were the most frequently reported ones and whose effects were most favorable.(4)The TCM had limited effects in controlling intraocular pressure and vision.(5)It was safe to treat open Angle glaucoma with traditional Chinese medicine.CONCLUSIONS Traditional Chinese medicine(TCM)is effective in improving the visual field of glaucoma patients.