耳穴压豆对糖尿病周围神经病变疗效影响的Meta分析

Meta-analysis of effect of ear acupoint pressing beans on diabetic peripheral neuropathy

目的通过Meta分析探讨耳穴压豆治疗糖尿病周围神经病变(DPN)的有效性, 为DPN的治疗提供参考。方法计算机检索中英文数据库中有关耳穴压豆治疗DPN的随机对照试验研究。检索时间为2006年1月1日-2021年12月16日。采用Cochrane手册的质量评价标准对纳入文献进行质量评价, 采用RevMan 5.3和Stata 16.0分析软件对多项研究结果的总体效应进行Meta分析。结果共纳入24篇随机对照试验, 合计1 773例患者。Meta分析结果显示, 耳穴压豆能有效改善DPN引起的感觉异常、肢体麻木、肌萎缩无力等症状(RR=1.30, 95%CI:1.22~1.38, P<0.01);提高正中运动神经传导速度(MNCV)(MD=3.46, 95%CI:2.74~4.17, P<0.01)、正中感觉神经传导速度(SNCV)(MD=1.81, 95%CI:0.89~2.72, P<0.01)、腓总MNCV (MD=4.71, 95%CI:3.82~5.59, P<0.01)、腓总SNCV (MD=4.68, 95%CI:3.30~6.06, P<0.01);降低糖化血红蛋白(P<0.05)。结论耳穴压豆对DPN的神经传导速度及临床症状都有很好的改善作用, 具有积极的临床意义。

Objective To evaluate the effectiveness of ear acupoint pressing beans in the treatment of diabetic peripheral neuropathy(DPN)by Meta-analysis and provide reference for the treatment of DPN.Methods Randomized controlled trial studies on ear acupoint pressing beans for DPN in Chinese and English databases were searched by the computer.The search time was from January 1,2006 to December 16,2021.The quality evaluation criteria of the Cochrane manual was used to evaluate the quality of the included literatures,and meta-analysis of the overall effects of the results was performed using RevMan 5.3 and Stata 16.0 analysis software.Results A total of 24 randomized controlled trials involving 1773 patients were included.The results of meta-analysis showed that ear acupoint pressing beans could effectively improve the symptoms of paresthesia,limb numbness,muscular atrophy and weakness caused by DPN(RR=1.30,95%CI:1.22-1.38,P<0.01),increased median motor nerve conduction velocity(MNCV)(MD=3.46,95%CI:2.74-4.17,P<0.01),median sensory nerve conduction velocity(SNCV)(MD=1.81,95%CI:0.89-2.72,P<0.01),common peroneal MNCV(MD=4.71,95%CI:3.82-5.59,P<0.01)and common peroneal SNCV(MD=4.68,95%CI:3.30-6.06,P<0.01)and decreased glycosylated hemoglobin(P<0.05).Conclusions Ear acupoint pressing beans can improve nerve conduction velocity and clinical symptoms of DPN,which has positive clinical significance.