中医外治法对干眼症患者疗效的网状Meta分析

A Mesh Meta-analysis of the Efficacy of External Treatment of Traditional Chinese Medicine in Patients with Dry Eye

目的采用贝叶斯网状Meta分析方法,评价中医外治法治疗干眼的有效性,为后续中医外治法治疗干眼的临床应用提供循证依据。方法计算机检索知网、万方、维普、中国生物医学文献数据库、PubMed、Embase、Cochrane Library中有关中医外治法治疗干眼的随机对照临床试验。检索时限为建库至2023年10月7日。应用Revman5.4、Stata17.0和R软件进行网状Meta分析。结果最终共纳入96篇文献,涉及干眼患者7675例,涵盖14种不同的干预措施。网状Meta分析结果显示,各类中医外治方案在有效率、泪膜破裂时间、泪液分泌试验方面具有不同的表现。艾灸+耳穴压豆+人工泪液三联疗法在治疗干眼有效率上表现最优;针刺+中药超声雾化在提高泪膜破裂时间上表现最优;耳穴压豆在提高泪液分泌量上表现最优。结论各类中医外治法的单用或联合应用治疗干眼症普遍优于人工泪液,并且不同的干预措施重点针对不同的治疗方向,建议结合患者症状表现及临床实际情况合理选择治疗方案。本研究结果值得临床推广,但因纳入文献的质量和数量的原因,仍需进行高质量、大样本的随机对照临床试验进一步验证。

Objective To evaluate the effectiveness of external treatment of dry eye with traditional Chinese medicine(TCM)by Bayesian network Meta-analysis,and to provide evidence-based evidence for the subsequent clinical application of external treatment of TCM in the treatment of dry eye.Methods CNKI,Wanfang,VIP,China Biomedical Literature Database,Pubmed,Embase and Cochrane Library were searched for randomized controlled clinical trials on the treatment of dry eye by external treatment of traditional Chinese medicine.The search time limit was from the establishment of the database to October 7,2023.Revman5.4,Stata17.0 and R were used for network meta-analysis.Results A total of 96 literatures were included,involving 7675 patients with dry eye,covering 14 different interventions.The results of network meta-analysis showed that different TCM external treatment schemes had different performance in terms of effective rate,tear film rupture time and tear secretion test.The triple therapy of moxibustion+auricular acupoint pressure+artificial tear is the best in the treatment of dry eye.Acupuncture+traditional Chinese medicine ultrasonic atomization has the best performance in improving tear film rupture time.Auricular acupoint pressure is the best in increasing tear secretion.Conclusion All kinds of external therapy of traditional Chinese medicine are generally better than artificial tears in the treatment of dry eye,and different interventions focus on different treatment directions.It is suggested to rationally select treatment plans according to the patient's symptoms and clinical situation.The results of this study are worthy of clinical promotion.However,due to the quality and quantity of the included literature,high-quality and large-sample randomized controlled clinical trials are still needed for further validation.