血府逐瘀汤治疗糖尿病脑病的Meta分析

The efficacy of Xuefu Zhuyu prescription for diabetic encephalopathy:A meta-analysis of randomized controlled trials

目的:对运用血府逐瘀汤治疗糖尿病脑病的安全性和有效性进行评价。方法:计算机检索和手工检索Pub Med、Web of Science、The Cochrane Library、知网、万方、维普及生物医学文献数据库2000年1月~2020年4月期间有关血府逐瘀汤治疗糖尿病脑病的临床随机对照研究,选择符合标准的文献运用Rev Man 5.3软件分析。结果:研究共纳入11篇文献和838例患者,Meta分析显示血府逐瘀汤在有效率[OR=3.71,95%CI(2.42,5.70),P<0.000 01]、患者神经功能缺损程度评分[MD=-4.52,95%CI(-5.10,-3.94),P<0.000 01]、空腹血糖[MD=-1.05,95%CI(-1.51,-0.59),P<0.000 01]、餐后2 h血糖[MD=-1.31,95%CI(-1.94,-0.69),P<0.000 01]、糖化血红蛋白[MD=-0.94,95%CI(-1.15,-0.72),P<0.000 01]、中医证候积分评分[MD=-2.44,95%CI(-3.82,-1.06),P=0.000 5]、生活能力评分[MD=12.79,95%CI(8.79,16.79),P<0.000 01]方面的改善效果明显优于西医常规治疗。结论:血府逐瘀汤能提高糖尿病脑病患者临床有效率,减轻患者脑部损害,降低血糖和糖化血红蛋白水平,具有良好的安全性。但部分纳入文献质量偏低,临床病例数较少,可能影响Meta分析结果的真实性,仍需高质量大样本的临床随机对照试验进一步验证。

Objective:To evaluate the safety and effectiveness of Xuefu Zhuyu Decoction in treating diabetic encephalopathy.Methods:Randomized controlled clinical trials on the treatment of diabetic encephalopathy with Xuefu Zhuyu Decoction were searched and retrieved from PubMed,Web of Science,The Cochrane Library,CNKI,WF,VIP and CBM from January 2000 to April 2020. Documents that meet the criteria for analysis were selected using Rev Man 5.3 software.Results:A total of 11 articles and 838 patients were included in the study. Meta-analysis showed that Xuefu Zhuyu Decoction was effective[OR=3.71,95% CI(2.42,5.70),P<0.000 01),and the patient ’s neurological deficit score[MD=-4.52,95% CI(-5.10,-3.94),P<0.00001],fasting blood glucose[MD=-1.05,95% CI(-1.51,-0.59),P<0.000 01),2 hours postprandial blood glucose[MD=-1.31,95% CI(-1.94,-0.69),P<0.000 01],glycated hemoglobin[MD=-0.94,95% CI(-1.15,-0.72),P<0.000 01],TCM symptom score[MD=-2.44,95% CI(-3.82,-1.06),P<0.01],vitality score[MD=12.79,95% CI(8.79,16.79),P<0.000 01],the improvement effect is significant better than conventional Western medicine treatment.Conclusions:Xuefu Zhuyu Decoction can improve the clinical efficiency of treating diabetic encephalopathy,reduce brain damage,blood glucose and glycated hemoglobin levels,and has good safety. But small sample size of some selected literatures may influence the quality of this Meta-analysis,thus the conclusion need to be further verified by high-quality clinical randomized controlled trials with large sample sizes.