穴位按摩辅助治疗糖尿病周围神经病变疗效的Meta分析

Meta analysis of clinical effect of acupoint massage adjuvant therapy for diabetic peripheral neuropathy

[目的]评价穴位按摩辅助治疗糖尿病周围神经病变(DPN)的疗效。[方法]计算机检索PubMed、中国科技期刊全文数据库(VIP)、中国知网(CNKI)、万方医学数据库(WanFang Data)、中国生物医学文献数据库(CBM)等,查找符合纳入标准的随机对照试验(RCT),文献检索时间均从建库截至2019年1月。由2名研究者独立筛选文献、提取数据及评价纳入研究的偏倚风险,采用RevMan 5.3对数据进行Meta分析或仅行描述性分析。[结果]共纳入17项RCT研究,包括1496例病人。Meta分析结果显示:临床总有效率,穴位按摩组优于常规治疗组(对照组)[OR=5.84,95%CI(4.32,7.90),P<0.00001];多伦多临床评分系统(Toronto clinical scoring system,TCSS)评分,穴位按摩组也优于常规治疗组[MD=-0.96,95%CI(-1.38,-0.54),P<0.00001]。[结论]穴位按摩辅助治疗糖尿病周围神经病变有一定疗效,但因纳入的绝大部分文献质量不高,且受文献数量限制,仍需更多高质量研究来证实。

Objective:To systematically evaluate the clinical effects of acupoint massage on diabetic peripheral neuropathy(DPN).Methods:The relevant randomized controlled trials(RCTs)which investigated the effects of massage therapy in the DPN were searched in PubMed,VIP,CNKI,WanFang,CBM,from the establishment of databases to January 2019.Two researchers independently screened literature,extracted data and assessed the risk of bias of the included studies.Revman 5.3 was used for Meta-analysis of the data or only for descriptive analysis.Results:A total of 17 RCTs involving 1496 patients were recruited.The results of Meta-analysis indicated that the total clinical effective rate of acupoint massage group was higher than that of conventional treatment group[OR=5.84,95%CI(4.32,7.90),P<0.00001];the Toronto Clinical Scoring System score of acupoint massage group was better than that of conventional treatment group[MD=-0.96,95%CI(-1.38,-0.54),P<0.00001].Conclusions:The current evidence indicated that acupoint massage had certain effect in the adjuvant therapy of DPN.However,due to the limited quantity and quality of included studies,the clinical efficacy still needed to be confirmed by more high-quality studies.