针灸对糖尿病周围神经病变病人SOD、TNF-α、hs-CRP和疗效影响的Meta分析

Influence of acupuncture and moxibustion on SOD,TNF-α,hs-CRP and therapeutic effect in DPN patients:a Meta-analysis

目的:系统评价针灸对糖尿病周围神经病变(DPN)病人超氧化物歧化酶(SOD)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)和疗效影响。方法:计算机检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、the Cochrane Library、PubMed、EMbase中关于针灸疗法治疗DPN的随机对照试验,检索时限为建库至2022年2月1日。经2名研究者筛选文献、提取信息与质量评价后,采用RevMan 5.4软件进行Meta分析。结果:最终纳入12项研究,涉及1104例病人。Meta分析结果显示,针灸能有效提高DPN病人SOD水平[MD=9.63,95%CI(5.70,13.56),P<0.00001],降低TNF-α[MD=-6.55,95%CI(-9.94,-3.16),P=0.0002]、hs-CRP[MD=-0.52,95%CI(-0.87,-0.17),P=0.003]水平,能改善病人疗效[OR=4.22,95%CI(2.95,6.02),P<0.00001]以及腓总神经运动传导速度[MD=4.83,95%CI(2.98,6.68),P<0.00001]、腓总神经感觉传导速度[MD=3.80,95%CI(2.15,5.46),P<0.00001]、正中神经运动传导速度[MD=4.25,95%CI(3.56,4.94),P<0.00001]、正中神经感觉传导速度[MD=6.05,95%CI(4.28,7.81),P<0.00001]。结论:现有证据表明,针灸对DPN病人具有良好疗效,可以改善DPN病人神经传导速度,提高SOD水平,降低TNF-α、hs-CRP水平。

Objective:To evaluate the effect of acupuncture and moxibustion on SOD,TNF-α,hs-CRP and therapeutic effect in DPN patients.Methods:Randomized controlled trials(RCTs)on acupuncture and moxibustion in DPN patients were searched from CNKI,WanFang Databases,VIP,CBM,the Cochrane Library,PubMed and EMbase.The retrieval time was from inception to February 1,2022.Literature screening,information extraction and quality evaluation were conducted by 2 reviewers,and RevMan 5.4 software was adopted for Meta-analysis.Results:A total of 12 RCTs were included,involving 1104 patients.Meta-analysis results showed that acupuncture and moxibustion can effectively improve the SOD level of DPN patients[MD=9.63,95%CI(5.70,13.56),P<0.00001],reduce TNF-αlevels[MD=-6.55,95%CI(-9.94,-3.16),P=0.0002],hs-CRP levels[MD=-0.52,95%CI(-0.87,-0.17),P=0.003],improve the efficacy[OR=4.22,95%CI(2.95,6.02),P<0.00001],motor conduction velocity of common peroneal nerve[MD=4.83,95%CI(2.98,6.68),P<0.00001],sensory conduction velocity of common peroneal nerve[MD=3.80,95%CI(2.15,5.46),P<0.00001],motor conduction velocity of median nerve[MD=4.25,95%CI(3.56,4.94),P<0.00001],sensory conduction velocity of median nerve[MD=6.05,95%CI(4.28,7.81),P<0.00001].Conclusion:Current evidence shows that acupuncture has a good effect on DPN patients which could,improve nerve conduction velocity,increase SOD level,reduce TNF-αand hs-CRP level.