中医活血利水方药治疗白内障术后继发黄斑水肿疗效和安全性的Meta分析

A Meta-analysis of Efficacy and Safety of Chinese Medicine in Treating Secondary Macular Edema after Cataract Surgery with Blood and Water Activating Formulae

目的系统评价中医活血利水方药治疗白内障术后继发黄斑水肿的疗效和安全性。方法运用计算机检索中国知网、万方、维普、PubMed等中英文数据库中涉及中医活血利水方药治疗白内障术后黄斑水肿的临床随机对照试验,检索时限为建库至2022年1月。采用RevMan 5.4统计软件进行Meta分析和统计处理。结果共筛选出符合纳入、排除标准的文献14篇。Meta分析结果显示,观察组治疗有效率高于对照组(RR=4.35,95%CI 2.96~6.41,P<0.00001),黄斑中心凹厚度小于对照组(MD=-23.08,95%CI-37.01~-9.16,P=0.001)。两组最佳矫正视力、眼压波动情况、不良反应发生率比较差异无统计学意义(MD=0.06,95%CI-0.01~0.13,P=0.08;MD=-0.53,95%CI-1.49~0.42,P=0.27;RR=0.50,95%CI 0.21~1.18,P=0.11)。Egger检验结果显示,临床疗效、最佳矫正视力不存在发表偏倚(P=0.112,P=0.368),黄斑中心凹厚度存在发表偏倚(P<0.001)。结论与单纯西医治疗相比,中医活血利水方药联合西医常规治疗白内障术后继发黄斑水肿的疗效更佳。

Objective To systematically evaluate the clinical efficacy and safety of traditional Chinese medicine(TCM)to treat secondary macular edema after cataract surgery.Methods The randomized controlled clinical studies on the treatment of macular edema after cataract surgery with TCM blood and water activating formulae were searched using a computer in CNKI,Wanfang Database,VIP Database and PubMed from database establishment to Jan.2022.Meta-analysis and statistical processing were performed using RevMan 5.4 statistical software.Results A total of 14 papers meeting the inclusion and exclusion criteria were screened.The results of Meta-analysis showed that the effective rate of the observation group was higher than that of the control group(RR=4.35,95%CI 2.96-6.41,P<0.00001),and the thickness of macular fovea was smaller than that of the control group(MD=-23.08,95%CI-37.01--9.16,P=0.001).The best corrected visual acuity,fluctuation of intraocular pressure and incidence of adverse reactions were not statistically significantly different between the two groups(MD=0.06,95%CI-0.01-0.13,P=0.08;MD=-0.53,95%CI-1.49-0.42,P=0.27;RR=0.50,95%CI 0.21-1.18,P=0.11).The Egger test results showed that there was no publication bias for clinical efficacy and optimal corrected vision(P=0.112,P=0.368),and there was publication bias for macular fovea thickness(P<0.001).Conclusion Compared with western medical treatment alone,the efficacy of TCM blood and water activating formulae combined with conventional western medical treatment for secondary macular oedema after cataract surgery is better.