水凝胶联合银离子敷料治疗糖尿病足的Meta分析

Meta analysis of hydrogel combined with silver ion dressing in treatment of diabetic foot

目的采用Meta分析方法来探讨水凝胶联合银离子敷料治疗糖尿病足的有效性和安全性。方法检索中国知网(CNKI)、维普(VIP)、万方(WanFang)、PubMed、Cochrane library和Embase数据库、中国临床注册中心、中国生物医学数据库(CBM)中有关于水凝胶联合银离子敷料治疗糖尿病足的研究,检索时间均为建库至2020年11月,对所纳入的研究进行严格的质量评价,利用RevMan 5.3软件对其有效率、清创时间、肉芽组织形成时间、上皮组织形成时间进行Meta分析。结果纳入7篇文献,共491例,治疗组为247例,对照组为244例。Meta分析结果显示:与对照组(常规治疗组)相比,水凝胶联合银离子敷料治疗疗效优于常规治疗组[I^(2)=0%,95%CI(2.04,10.43),P<0.05],且能缩短清创时间[I^(2)=0%,95%CI(-3.09,-2.53),P<0.05];肉芽组织出现时间提前[I^(2)=25%,95%CI(-3.89,-2.88),P<0.05];上皮组织形成时间缩短[I^(2)=35%,95%CI(-2.95,-2.30),P<0.05]。结论水凝胶联合银离子敷料治疗糖尿病足较常规治疗具有明显优势,但由于受纳入研究的数量和质量的限制,此结论尚待更多高质量的随机对照研究予以验证。

Objective Recently,hydrogel combined with silver ion dressing has been applied to the treatment of diabetic foot.However,the research findings are inconsistent because of the small sample size.This systematic review is helpful in studying the efficacy and safety of this therapy and provides evidence-based evidence.Methods The CNKI,VIP,Wan Fang,WanFang,PubMed,Cochrane library and Embase database,China clinical registry and China biomedical database(CBM)were searched for research on hydrogel and silver ion dressing for diabetic foot.The time of searching was from November 2020 to China.Revman 5.3 software was used to analyze the efficiency,debridement time,granulation tissue formation time and epithelial tissue formation time.Results A total of 7 articles with 491 cases were included,247 cases in the treatment group and 244 cases in the control group.Meta analysis showed that compared with the control group(conventional treatment group),hydrogel combined with silver ion dressing was better than the conventional treatment group[I^(2)=0%,95%CI(2.04,10.43),P<0.05],and could shorten the time of debridement[I^(2)=0%,95%CI(-3.09,-2.53),P<0.05].Granulation tissue appeared earlier[I^(2)=25%,95%CI(-3.89,-2.88),P<0.05].The time of epithelial tissue formation was shortened[I^(2)=35%,95%CI(-2.95,-2.30),P<0.05].Conclusion Hydrogel combined with silver ion dressing is superior to conventional therapy in the treatment of diabetic foot.However,because of the limited quantity and quality of the included studies,this conclusion needs more high-quality randomized controlled trials.