穴位注射治疗糖尿病周围神经病变有效性的Meta分析

Effect of acupoint injection on diabetic peripheral neuropathy:a Meta-analysis

目的:系统评价穴位注射治疗糖尿病周围神经病变的有效性。方法:通过计算机检索中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方数据库(WanFang Database)、维普数据库(VIP)、PubMed、Web of Science、the Cochrane Library、EMbase数据库中关于穴位注射治疗糖尿病周围神经病变的随机对照试验(RCT),检索时间为各数据库建库至2021年4月1日。由2名研究者独立进行文献筛选、质量评价、资料提取,使用RevMan 5.3软件进行Meta分析。结果:共纳入11篇文献,涉及972例病人。Meta分析结果显示,穴位注射治疗糖尿病周围神经病变的临床有效率高[RR=1.23,95%CI(1.16,1.31),P<0.00001],可提高正中神经运动神经传导速度[SMD=1.03,95%CI(0.84,1.22),P<0.00001]、正中神经感觉神经传导速度[SMD=0.65,95%CI(0.48,0.82),P<0.00001]、腓总神经运动神经传导速度[SMD=0.97,95%CI(0.12,1.82),P=0.02],但不能提高糖尿病周围神经病变病人的腓总神经感觉神经传导速度[SMD=0.92,95%CI(-0.09,1.93),P=0.08]。结论:现有证据表明,与常规静脉给药治疗相比,穴位注射治疗能提高糖尿病周围神经病变病人的临床有效率,提高正中神经感觉神经传导速度、正中神经运动神经传导速度以及腓总神经运动神经传导速度,有利于改善临床症状体征,但不能提高腓总神经感觉神经传导速度。

Objective:To systematically evaluate the efficacy of acupoint injection in the treatment of diabetic peripheral neuropathy.Methods:A randomized controlled trial(RCT)on the treatment of diabetic peripheral neuropathy by acupoint injection were retrieved from CNKI,CBM,WanFang Database,VIP,PubMed,Web of Science,the Cochrane Library,EMbase and other databases.The search time is from the establishment of each database to April 1,2021.Literature screening,quality evaluation,and data extraction were independently carried out by two researchers,and RevMan 5.3 software was used for Meta-analysis.Results:A total of 11 articles were included,involving 972 patients.Meta-analysis results showed that acupoint injection has a high clinical effectiveness in the treatment of diabetic peripheral neuropathy[RR=1.23,95%CI(1.16,1.31),P<0.00001],and can increase the median nerve motor nerve conduction velocity[SMD=1.03,95%CI(0.84,1.22),P<0.00001],median nerve sensory nerve conduction velocity[SMD=0.65,95%CI(0.48,0.82),P<0.00001],common peroneal nerve motor nerve conduction velocity[SMD=0.97,95%CI(0.12,1.82),P=0.02],can improve clinical symptoms and signs.Conclusion:Currrent evidence shows that compared with conventional intravenous treatment,acupoint injection therapy can improve the clinical effectiveness of patients with diabetic peripheral neuropathy,increase the median nerve sensory nerve conduction velocity,median nerve motor nerve conduction velocity,and common peroneal nerve motor nerve conduction velocity,which is beneficial to improve clinical symptoms and signs,but can not increase the common peroneal nerve sensory nerve conduction velocity.