中药内服联合足浴治疗糖尿病周围神经病变疗效的Meta分析

Meta-analysis of Chinese Herbal Oral Administration combined with Foot Bath in the Treatment of Diabetic Peripheral Neuropath

目的:系统评价中药内服联合足浴治疗糖尿病周围神经病变(DPN)的疗效。方法:计算机检索万方数据库、中国知网(CNKI)、维普数据库(VIP)、中国生物医学文献数据库(CBM)、Cochrane图书馆、Embase、Medline以及PubMed数据库中中药内服联合足浴治疗DPN的随机对照试验(RCT),然后进行文献筛选、文献质量评价并提取资料,采用RevMan5.3软件进行Meta分析。结果:共纳入13项RCT研究,包括925例患者。Meta分析结果显示,中药内服联合足浴能提高DPN患者总有效率[RR=1.28,95%CI(1.21,1.36),P<0.000,01];中药内服联合足浴能提高DPN患者腓总神经运动神经传导速度(MCV)[MD=2.24,95%CI(1.55,2.93),P<0.000,01])]、腓总神经感觉神经传导速度(SCV)[MD=2.51,95%CI(1.43,3.60),P<0.000,01]、正中神经SCV[MD=2.21,95%CI(-0,29,4.53),P=0.08];中药内服联合足浴能降低DPN患者多伦多临床评分系统(TCSS)评分[MD=-2.58,95%CI(-3.57,-1.59),P<0.000,01]和症状积分[MD=-2.46,95%CI(-2.99,-1.93),P<0.000,01]。结论:中药内服联合足浴治疗DPN患者有一定的疗效,但由于现有研究整体质量偏低、样本量较小,需要更多多中心、高质量的RCT、双盲试验进一步验证其疗效。

Objective:To systematically assess the efficacy of herbal oral administration combined with foot bath in the treatment of diabetic peripheral neuropath(DPN).Methods:Through searching Wanfang database,CNKI,VIP,CBM,Cochrane Library,Embase,Medline and PubMed database,randomized controlled trials(RCTs)of the curative effect of herbal oral administration combined with foot bath on DPN patients were detected,and then literature screening,literature quality evaluation and data extraction were carried out.Finally,RevMan5.3 software was used for Meta-analysis.Results:13 RCT studies and 925 patients were included in the study.The results of Meta-analysis showed that the total effective rate of DPN patients could be increased by Chinese herbal oral administration combined with foot bath[RR=1.28,95%CI(1.21,1.36),P<0.000,01].The MCV of the common peroneal nerve[MD=2.24,95%CI(1.55,2.93)P<0.000,01],SCV of the common peroneal nerve[MD=2.51,95%CI(1.43,3.60),P<0.000,01)],SCV of the median nerve[MD=2.21,95%CI(-0.29,4.53),P=0.08]in DPN patients can be increased by the combination therapy.Chinese herbal oral administration combined with foot bath could reduce the scores of TCSS[MD=-2.58,95%CI(-3.57,-1.59),P<0.000,01]and symptom scores[MD=-2.46,95%CI(-2.99,-1.93),P<0.000,01].Conclusion:Chinese herbal oral administration combined with foot bath has obvious curative effect in the treatment of diabetic peripheral neuropath.While more multi-center,high-quality RCTs and double-blind trials are needed to verify its efficacy because of the low overall quality and small sample size of the existing research.