中药足浴联合甲钴胺治疗糖尿病周围神经病变系统评价

A Systematic Review of Foot Bath of Traditional Chinese Medicine Combining Mecobalamin on Diabetic Peripheral Neuropathy

目的:中药足浴联合甲钴胺治疗糖尿病周围神经病变的疗效以及安全性。方法:通过计算机检索和手工检索收集2000—2018年18年间以中药足浴联合甲钴胺为干预措施治疗糖尿病周围神经病变的随机对照实验。按Cochrane系统评价方法,由两位研究者独立地对符合纳入标准的试验进行资料提取,并进行研究方法的质量评估和对提取的有效数据进行Meta析。结果:有14个试验,共1032名患者符合纳入标准,Meta分析结果显示,在常规西药治疗的基础上加用中药足浴联合甲钴胺治疗,可以进一步改善糖尿病周围神经病变的症状、疗效以及改善患者神经传导速度,优于单纯应用西医治疗。试验组与对照组差异显著[OR=4.31,95%CI(3.03,6.03),Z=8.13,(P<0.00001)]。结论:中药足浴联合甲钴胺治疗,是糖尿病周围神经病变有效的治疗方案,优于西医常规药物治疗,但还需进行更多高质量的RCT以提高证据级别。

Objective:To evaluate the effect and safety of foot bath of traditional Chinese medicine combining mecobalamin on diabetic peripheral neuropathy. Methods:Randomized controlled trials of foot bath of traditional Chinese medicine combining mecobalamin as an intervention for the treatment of on diabetic peripheral neuropathy during 2000—2018 over a 18-year period by computerized and manual retrieval were collected. According to the Cochrane systematic review,two investigators independently extracted data from eligible trials and assessed the quality of the research methods and Meta-analysis of the extracted valid data. Results:A total of 1032 patients met the inclusion criteria in 14 trials. The results of Meta analysis showed that foot bath of traditional Chinese medicine combining mecobalamin on the basis of conventional Western medicine can further improve the symptoms,curative effect and improve nerve conduction velocity in patients. There was significant difference between acupuncture group and control group (OR=4.31,95% Cl(3.03,6.03),Z=8.13,(P<0.00001))Conclusion:Foot bath of traditional Chinese medicine combining mecobalamin is an effective treatment for diabetic peripheral neuropathy,which is superior to Western medicine. However,more high quality RCTs are needed to improve the evidence level.